The Role of the Allergist in the Management of Chemotherapy-Induced Hypersensitivity Reactions

Chemotherapy-Induced Hypersensitivity Reactions are one of the main problems for oncology physicians and chemotherapy patients. The hypersensitivity reaction can either cause the cessation of the first-line treatment and it may impair the final result and impede or decrease the chances for successful treatment. Chemotherapy drugs are foreign substances that are capable to inducing the various hypersensitivity reactions from mild cutaneous symptoms to severe respiratory distress and cardiovascular collapse. The original Gell and Coomb’s classification categorizes hypersensitivity reactions into four types according to the type of immune response and the effector mechanism responsible for cell and tissue injury. The most common reactions are caused by platinum compounds, taxanes, epipodophyllotoxins, and asparaginase. The use of biologicals is increasing now, and these drugs are frequent causes of hypersensitivity reactions too. Skin testing is a method of diagnosing drug hypersensitivity, but it has not been developed enough in the field of medical oncology where a variety of the antineoplastic agents may be caused hypersensitivity reactions. Drug desensitization is the benefitial therapy in patients with chemotherapyinduced hypersensitivity reactions to chemotherapeutic drugs. This is useful for chemotherapy patients with malignancies and hematological diseases when no comparable alternative is available.