High prevalence of antibiotic allergies in cladribine-treated patients with hairy cell leukemia–lessons for immunopathogenesis and prescribing

Abstract

The relationship between hematological malignancy and chemotherapy on the prevalence of antibiotic allergy label (AAL) is ill-defined. We performed a multicenter retrospective case-control study comparing AAL rates among cladribine-treated hairy cell leukemia (C-HCL) cases, non-HCL cladribine-treated controls (control-1), and fludarabine-treated controls (control-2). The prevalence of AALs in C-HCL patients was 60%, compared with control-1 (14%, p <.01) and control-2 patients (25%, p <.01). The predominant phenotype was maculopapular exanthem (92%). The drugs implicated in AAL causality in C-HCL patients included beta-lactams (81%), trimethoprim–sulfamethoxazole (58%), and allopurinol (69%)...