Food, drug, insect sting allergy, and anaphylaxisHypersensitivity reactions to chemotherapy: Outcomes and safety of rapid desensitization in 413 cases
Section snippets
Patients
This collaboration between investigators at Dana Farber Cancer Institute (DFCI) and Brigham and Women's Hospital (BWH; Allergy and Medical Intensive Care divisions) was approved by the Human Research Committee (institutional review board protocol no. 2007-P-000050/1). Between January 1, 2005, and October 31, 2006, patients with known HSRs to chemotherapy were referred to the allergy service for rapid desensitization.
The inclusion criteria were (1) age greater than 18 years, (2) ability to
Patient characteristics
Over 22 months, 98 patients with HSRs to chemotherapy, including rituximab, received rapid desensitization. Patients' ages ranged from 30 to 78 years (mean, 55 years). Ninety-seven patients were being treated for a malignancy (1 male and 96 female patients), and 1 patient was being treated for polymyositis. The most common malignancies were ovarian, breast, and peritoneal (Table III). Twenty-five patients were treated for primary cancers, and 72 were treated for recurrent cancers. Three
Discussion
We present the results of the first large-scale series of desensitizations carried out in 98 patients by using the standardized protocol developed at our institutions. Over the course of 22 months, 413 rapid desensitizations to various chemotherapeutic agents, including rituximab, were performed, in which no deaths occurred; moreover, all patients received their full target dose, demonstrating the efficacy of the procedure. In our hands the protocol has been uniformly successful in permitting
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Supported by the Ovations for the Cure Desensitization Program.
Disclosure of potential conflict of interest: D. E. Sloane has received honoraria from Genentech. F. I. Hsu has served as a coinvestigator for Dyax Corporation and has received a research grant from the American Academy of Allergy, Asthma & Immunology. N. A. Barrett has served as a coinvestigator for the National Institutes of Health and has served as a primary investigator for the American Academy of Allergy, Asthma & Immunology and Altana. D. I. Hong and T. M. Laidlaw have received training grant salary from the National Institutes of Health. S. N. Nallamshetty has received training grant salary from the National Institutes of Health and research grants from the American Academy of Allergy, Asthma & Immunology and GlaxoSmithKline. S. M. Campos has served as a research consultant for Genentech and has received research support from Genentech, Novartis, and Ortho-Biotechnology. The rest of the authors have declared that they have no conflict of interest.
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These authors contributed equally to this work.