title: Anaphylaxis to chemotherapy and monoclonal antibodies.
abstract: Hypersensitivity reactions are increasingly prevalent, although underrecognized and underreported. Platins induce immunoglobulin E-mediated sensitization; taxenes and some monoclonal antibodies can induce reactions at first exposure. Severe hypersensitivity can preclude first-line therapy. Tryptase level at the time of a reaction is a useful diagnostic tool. Skin testing provides a specific diagnosis. Newer tests are promising diagnostic tools to help identify patients at risk before first exposure. Safe management includes rapid drug desensitization. This review provides information regarding the scope of hypersensitivity and anaphylactic reactions induced by chemotherapy and biological drugs, as well as diagnosis, management, and treatment options.
authors.affiliation: Allergy Immunology Training Program, Drug Hypersensitivity and Desensitization Center, Mastocytosis Center, Brigham and Women's Hospital, Harvard Medical School, 1 Jimmy Fund Way, Boston, MA 02115, USA. Electronic address: mcastells@partners.org.
authors.forename: Mariana C
authors.initials: MC
authors.lastname: Castells
mesh_terms: D000707:Anaphylaxis / Q000175:diagnosis* / Q000276:immunology* / Q000628:therapy; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D012882:Skin Tests; D053802:Tryptases
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D007073:Immunoglobulin E; D053802:Tryptases
keywords: Anaphylaxis; Chemotherapy; Monoclonal antibodies; Platins; Rapid desensitization; Skin testing; Taxenes; Tryptase