Implementation of Rapid Drug Desensitization in Antineoplastic Drug Therapy in Denmark Using One-Bag Protocols

IF 4 2区 医学 Q2 ALLERGY
Trine Holm Rasmussen, Charlotte Gotthard Mortz, Per Pfeiffer, Nina Andersen, David George Mawn, Line Kring Tannert, Millie Nguyen Basu, Helene Marlies Rasmussen, Carsten Bindslev-Jensen
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引用次数: 0

Abstract

Background

Rapid drug desensitization (RDD) is the cornerstone of managing patients with immediate drug hypersensitivity reactions (IDHR) to antineoplastic drugs in Southern Europe and the United States. As the first in Northern Europe, an allergy treatment program that includes RDD and drug provocation testing (DPT) was implemented for Danish patients with cancer. We report the results of this allergy intervention, the number of successful treatments, the fraction, timing and severity of breakthrough reactions (BTR) and the actual treatment duration of RDD procedures.

Methods

This was a prospective observational study. Patients with IDHRs to antineoplastic drugs referred to the allergy treatment program were included. Patients were followed up until finalization of DPT and/or RDD. RDDs were performed according to one-bag RDD-protocols with drug concentrations strictly following manufacturer's instructions and infusion sets primed with flushing fluid. The outcome of DPTs and RDDs were recorded together with detailed information on BTRs and treatment duration of RDD-procedures.

Results

During 28 months, 72 patients were included. With DPT, a safe drug alternative was found for five drugs, hypersensitivity was ruled out for six, and one treatment was discontinued after a positive DPT. RDD was performed in 60 patients. Of 248 initiated RDD procedures, 247 were completed. BTRs were observed in 53% of patients and 27% of RDD-procedures, with most BTRs being mild to moderate. The treatment duration was below 6 hours in 96% of RDD procedures.

Conclusion

The allergy treatment program, which included DPT and one-bag RDD-protocols, allowed patients to continue critical antineoplastic treatments despite IDHRs.

Abstract Image

丹麦使用一袋方案在抗肿瘤药物治疗中快速脱敏的实施
背景:在南欧和美国,快速药物脱敏(RDD)是治疗抗肿瘤药物立即药物超敏反应(IDHR)患者的基础。作为北欧第一个,丹麦对癌症患者实施了包括RDD和药物激发试验(DPT)在内的过敏治疗方案。我们报告了这种过敏干预的结果,成功治疗的数量,突破反应(BTR)的比例,时间和严重程度以及RDD程序的实际治疗持续时间。方法前瞻性观察性研究。对抗肿瘤药物过敏反应的患者纳入过敏治疗方案。对患者进行随访,直至DPT和/或RDD最终确定。按照单袋rdd方案进行rdd,药物浓度严格按照制造商的说明进行,输液器注入冲洗液。记录dpt和rdd的结果以及btr的详细信息和rdd程序的治疗时间。结果随访28个月,共纳入72例患者。对于DPT,发现了五种药物的安全替代药物,排除了六种药物的过敏,并且在DPT阳性后停止了一种治疗。60例患者行RDD。在248个启动的RDD程序中,完成了247个。在53%的患者和27%的rdd手术中观察到btr,大多数btr为轻度至中度。96%的RDD治疗持续时间低于6小时。结论过敏治疗方案包括DPT和一袋rdd方案,允许患者在IDHRs的情况下继续进行关键的抗肿瘤治疗。
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来源期刊
Clinical and Translational Allergy
Clinical and Translational Allergy Immunology and Microbiology-Immunology
CiteScore
7.50
自引率
4.50%
发文量
117
审稿时长
12 weeks
期刊介绍: Clinical and Translational Allergy, one of several journals in the portfolio of the European Academy of Allergy and Clinical Immunology, provides a platform for the dissemination of allergy research and reviews, as well as EAACI position papers, task force reports and guidelines, amongst an international scientific audience. Clinical and Translational Allergy accepts clinical and translational research in the following areas and other related topics: asthma, rhinitis, rhinosinusitis, drug hypersensitivity, allergic conjunctivitis, allergic skin diseases, atopic eczema, urticaria, angioedema, venom hypersensitivity, anaphylaxis, food allergy, immunotherapy, immune modulators and biologics, animal models of allergic disease, immune mechanisms, or any other topic related to allergic disease.
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