title: Desensitizations for chemotherapy and monoclonal antibodies: indications and outcomes.
abstract: Acute infusion reactions to both chemotherapeutic agents and humanized monoclonal antibodies can occur, which may limit therapeutic options for treatment of malignancies and chronic inflammatory diseases. Many of these acute infusion reactions are consistent with a type I hypersensitivity reaction, including anaphylaxis. If a patient experiences a significant acute infusion reaction, often the recommendation is to discontinue the medication and find an alternative agent. However, the "second-line" agent may be more toxic or inferior. If the reaction is likely a type I or type IV hypersensitivity reaction, one option is to undergo desensitization to the offending drug. Drug desensitization is the process of readministering a needed drug in incremental doses over hours or days until a full therapeutic dose is tolerated. This article will review the current literature on indications and outcomes for drug desensitization in the management of allergy to either chemotherapeutic agents or monoclonal antibodies.
authors.affiliation: Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 850 Boylston Street Suite 540, Chestnut Hill, MA, 02467, USA, khsublatman@partners.org.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Hsu Blatman
authors.forename: Mariana C
authors.initials: MC
authors.lastname: Castells
mesh_terms: D000911:Antibodies, Monoclonal / Q000276:immunology* / Q000627:therapeutic use; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D012882:Skin Tests; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007073:Immunoglobulin E