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
{"title":"丹麦使用一袋方案在抗肿瘤药物治疗中快速脱敏的实施","authors":"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","doi":"10.1002/clt2.70093","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The allergy treatment program, which included DPT and one-bag RDD-protocols, allowed patients to continue critical antineoplastic treatments despite IDHRs.</p>\n </section>\n </div>","PeriodicalId":10334,"journal":{"name":"Clinical and Translational Allergy","volume":"15 8","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clt2.70093","citationCount":"0","resultStr":"{\"title\":\"Implementation of Rapid Drug Desensitization in Antineoplastic Drug Therapy in Denmark Using One-Bag Protocols\",\"authors\":\"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\",\"doi\":\"10.1002/clt2.70093\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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. 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Implementation of Rapid Drug Desensitization in Antineoplastic Drug Therapy in Denmark Using One-Bag Protocols
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.
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.