DRUG DESENSITIZATION CHARACTERIZATION: AN INSTITUTIONAL EXPERIENCE

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology Pub Date : 2024-10-25 DOI:10.1016/j.anai.2024.08.070

A. Heffes-Doon, S. Lee, J. Chin-Hon, E. Banta

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引用次数: 0

Abstract

Introduction

Chemotherapy desensitization is utilized following hypersensitivity reactions (HSR) to allow for continued administration of medication following type 1 reactions (type 1), cytokine release reactions (CRR) and mixed reactions (both type 1 and CRR). We describe our institutional experience with desensitization.

Methods

We reviewed the charts of patients with HSR referred to allergy and immunology for desensitization, 18-95 years of age, between 2018 to 2024.

Results

Forty-four patients with immediate HSR and desensitization were reviewed; 10 (23%) males, and 34 females (77%), with a mean age of 62.7 years. Indications for treatment were malignancy (80%), autoimmune disease (18%) and anemia (2%). Index reactions (IR) were type 1 (n= 29, 65.9%), mixed (n=10, 22.7%), and CRR (n= 4, 9.1%). Grade 2 IR severity was most common (30.2%), followed by grade 4 (25.6%) and grade 3 (25.6%). Trigger medications included platinum agents (45.4%), anti-CD20 monoclonal antibodies (mAbs) (38.6%) and taxanes (11.4%). The most common desensitization protocol used was a 12-step (93.2%). Forty-one (93%) patients completed desensitization. Three patients (2 rituximab, 1 ocrelizumab) did not due to reactions during desensitization. Nine breakthrough reactions (BR) occurred, of these, 6 completed the desensitization. No mortality related to desensitization occurred.

Conclusion

Desensitization performed in a facility with anaphylaxis-preparedness is an effective method of administering medications to patients with HSR. All patients undergoing desensitization to platinum agents and taxanes completed desensitization, while 3 patients receiving an anti-CD20 mAb did not due to BR symptoms.

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药物脱敏特征描述：机构经验

导言化疗脱敏是在超敏反应（HSR）发生后进行的，以便在发生1型反应（1型）、细胞因子释放反应（CRR）和混合反应（1型和CRR）后继续用药。我们介绍了本机构在脱敏治疗方面的经验。方法我们回顾了 2018 年至 2024 年间转诊至过敏与免疫科进行脱敏治疗的 HSR 患者病历，患者年龄在 18-95 岁之间。结果回顾了 44 名立即接受 HSR 和脱敏治疗的患者；其中男性 10 人（23%），女性 34 人（77%），平均年龄 62.7 岁。治疗指征为恶性肿瘤（80%）、自身免疫性疾病（18%）和贫血（2%）。指数反应（IR）为1型（29例，65.9%）、混合型（10例，22.7%）和CRR（4例，9.1%）。IR 严重程度 2 级最常见（30.2%），其次是 4 级（25.6%）和 3 级（25.6%）。触发药物包括铂类药物（45.4%）、抗CD20单克隆抗体（mAbs）（38.6%）和类固醇类药物（11.4%）。最常用的脱敏方案是 12 步疗法（93.2%）。41名患者（93%）完成了脱敏治疗。三名患者（2 名利妥昔单抗患者，1 名奥克利珠单抗患者）因脱敏过程中出现反应而未完成脱敏。发生了 9 例突破性反应 (BR)，其中 6 例完成了脱敏治疗。结论在有过敏性休克准备的机构中对 HSR 患者进行脱敏治疗是一种有效的用药方法。所有接受铂类药物和类固醇类药物脱敏治疗的患者都完成了脱敏治疗，而3名接受抗CD20 mAb治疗的患者因出现BR症状而没有完成脱敏治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Allergy Asthma & Immunology 医学-过敏

CiteScore

6.50

自引率

6.80%

发文量

437

审稿时长

33 days

期刊介绍： Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.