Yonsei Med J.  2019 Feb;60(2):119-125. 10.3349/ymj.2019.60.2.119.

Desensitization for Allergic Reactions to Chemotherapy

• Hong DI

• KMID: 2431627
• DOI: http://doi.org/10.3349/ymj.2019.60.2.119

Abstract

Drug desensitization is procedure by which patients can be tolerized to medications that have previously induced hypersensitivity reactions. Initially used in treating hypersensitivity reactions to antibiotics, desensitization is now frequently used in the setting of allergy to chemotherapy drugs and biologics, thus widening the clinical applicability of this procedure which has been proven to be quite safe and effective in improving clinical outcomes, mainly by allowing patients to remain on preferred first-line therapy. This paper reviews the history, application, and safety studies of drug desensitization for chemotherapy and biologics.

Keyword

Drug hypsersensitivity; desensitization; anaphylaxis

MeSH Terms

Anaphylaxis
Anti-Bacterial Agents
Biological Products
Drug Therapy*
Humans
Hypersensitivity*
Anti-Bacterial Agents
Biological Products

Figure

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  Fig. 1 Example of a 3-bag, 12-step desensitization protocol for carboplatin.

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  Fig. 2 Example of 1-bag, 3-step challenge protocol for Taxol.

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  Fig. 3 Safety of desensitizations. (A) The overall number and severity of breakthrough reactions occurring during all desensitization from 2007 to 2010 at Brigham and Women's Hospital/Dana-Farber Cancer Institute is shown as a total of all desensitizations (2177) along with (B) specific data for carboplatin, rituximab, and paclitaxel, the most commonly desensitized drugs. (C) Breakdown of breakthrough reactions for all desensitizations. Adapted from Sloane, et al. J Allergy Clin Immunol Pract 2016;4:497-504, with permission of Elsevier [32].

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  Fig. 4 Kaplan-Meier curve comparing surivival of patients receiving carboplatin by desensitization (red) vs. normal infusion (black). Adapted from Sloane, et al. J Allergy Clin Immunol Pract 2016;4:497-504, with permission of Elsevier [32].

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