Outcomes and safety of rapid desensitization for chemotherapy hypersensitivity.
BACKGROUND
The incidence of hypersensitivity reactions (HSRs) to chemotherapy agents has increased because of increasing number of cancer survivors are exposed to repeated courses of sensitizing agents. Replacement with an alternative chemotherapy regimen is often limited by tumor sensitivity. Rapid desensitization offers an effective mean to allow continuation of the treatment to which patients have presented HSRs.


METHODS
We review the methods, outcome and safety of the rapid desensitization protocol developed at Brigham and Women's Hospital, Harvard Medical School Affiliate, based on our recent publication "'Hypersensitivity reactions to chemotherapy: outcome and safety of rapid desensitization in 413 cases". Literature search was conducted through Medline (from January 1976 to September 2009), using PubMed.


RESULTS
The article will give insight to clinical manifestations of immediate HSR to various chemotherapy agents and their presumably different immunopathomechanism. Risk assessment, including skin testing in those presented HSRs to platins and details on rapid desensitization process and its pitfalls will be discussed.


CONCLUSIONS
Standa"rd protocol of rapid desensitization, administering under multidisciplinary team approach, is safe and effective in overcoming immediate HSRs to platins, taxanes, doxorubicin and rituximab via both intravenous and intraperitoneal routes.
Limsuwan
Ticha
T
Mahidol University, Ramathibodi Hospital, Division of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Rama 6th Road, Phyathai, Bangkok 10400, Thailand.
Castells
Mariana C
MC
D000328:Adult; D000368:Aged; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002985:Clinical Protocols; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D004342:Drug Hypersensitivity / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000276:immunology; D016032:Randomized Controlled Trials as Topic; D012882:Skin Tests; D016896:Treatment Outcome
D018926:Anti-Allergic Agents; D000970:Antineoplastic Agents