Abstract
An in vitro T-cell activation assay measuring granulysin and granzyme B has been used to identify the drug hypersensitivity of common causative drugs, but not of chemotherapeutic drugs. Both granulysin and granzyme B are cytotoxic molecules involved in skin eruptions during drug hypersensitivity. Herein, we report the first clinical application of an in vitro T-cell activation assay to identify the causative agent in docetaxel, cisplatin, and 5-fluorouracil (5-FU)-related hypersensitivity in a patient with head-and-neck cancer. A significant increase in granulysin and granzyme B was observed for 5-FU rather than for docetaxel or cisplatin. Despite several limitations, we were still able to pinpoint 5-FU as the culprit drug in a chemotherapy combination without further drug rechallenge in our patient. In conclusion, an in vitro T-cell activation assay measuring granulysin and granzyme B can be a safe and alternative tool to determine the causative agent of hypersensitivity reactions in cancer patients who need combination chemotherapy.
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