title: Malignancy and specific allergen immunotherapy: the results of a case series.
abstract: BACKGROUND
  Specific immunotherapy with allergen is the only causative treatment for IgE-mediated allergies such as stinging insect allergy or hay fever and works by the induction of blocking antibodies and regulatory T lymphocytes.
  
  
  OBJECTIVE
  Does a hypothetical obstruction of tumor surveillance presupposing the induction of regulatory T cells really justify detaining immunotherapy to oncologic patients as suggested by recent guidelines?
  
  
  METHODS
  We report 6 patients (4 female, 2 male) suffering or having suffered from stage 1 cancer (4 melanomas, 1 lung cancer, 1 breast cancer) and concomitant IgE-mediated allergy. Four of them had a history of severe anaphylactic reactions to the insect yellow jacket, the 5th suffered from allergic rhinoconjunctivitis to dust mites, and the 6th to grass/rye pollen.
  
  
  RESULTS
  Between 2004 and 2010, subcutaneous immunotherapy was safely performed in 5 patients without signs of tumor reactivation. The cancer in 2 of them was diagnosed immediately after specific immunotherapy had been initiated and in another 2 the active cancer phase had already finished years before; the 5th suffered from a relapse around the time of the initiation of immunotherapy. At the time of the writing of the manuscript, 4 of them had already concluded 3 years of treatment, another one almost 1 year. The melanoma in the 6th patient was diagnosed 5 months after reaching the maintenance dose. Immunotherapy with grass/rye pollen was aborted in this patient based on current guidelines.
  
  
  CONCLUSIONS
  Specific immunotherapy was safely administered in patients suffering concomitantly from IgE-mediated allergy and lower stage cancer.
authors: Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria. stefan.woehrl@meduniwien.ac.at
authors: Stefan
authors: S
authors: Wöhrl
authors: Tamar
authors: T
authors: Kinaciyan
authors: Ahmad
authors: A
authors: Jalili
authors: Georg
authors: G
authors: Stingl
authors: Katharina B
authors: KB
authors: Moritz
mesh_terms: D000328:Adult; D000368:Aged; D000707:Anaphylaxis; D000818:Animals; D001943:Breast Neoplasms / Q000150:complications; D003888:Desensitization, Immunologic / Q000009:adverse effects; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000276:immunology / Q000628:therapy*; D007073:Immunoglobulin E; D008129:Lolium / Q000276:immunology; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008545:Melanoma / Q000150:complications; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011058:Pollen / Q000276:immunology; D039981:Pyroglyphidae / Q000276:immunology; D014863:Wasps / Q000276:immunology
chemical_list: D007073:Immunoglobulin E