Abstract
Background The need to offer first-line therapy to the increasing number of patients who have suffered an hypersensitivity reaction has stimulated the use of rapid desensitization protocols. Objective To present our experience working as a multidisciplinary team using a rituximab rapid desensitization scheme. Method Patient demographics, allergic reaction, skin tests to rituximab, number of desensitizations, reactions during the desensitization protocol and actions taken, number of administered and completed cycles, were retrospectively collected in patients who received at least one desensitization to rituximab. Main outcomes Number of desensitizations successfully managed. Results Between 2012 and June 2013 five patients received a total of 19 desensitizations to rituximab using a 12 step rapid desensitization protocol. All patients received the scheduled chemotherapeutic cycles as inpatients, with no delay in administration dates. Three patients presented a hypersensitivity reaction during the first desensitization and in one patient the event occurred again during the second treatment cycle. All reactions occurred in the last step, when the infusion rate reached the maximum speed. Conclusion The developed protocol for rapid desensitization was successful in five patients receiving rituximab. Patients could receive the full intended dose.
This is a preview of subscription content, log in via an institution to check access.
References
Go AC, Barber GR, Dreskin SC. Implementing standardized intravenous antibiotic desensitizations among hospital inpatients. Am J Health Syst Pharm. 2013;70:540–8.
Castells MC, Tennant NM, Sloane DE, Hsu FI, Barrett NA, Hong DI. Hypersensitivity reactions to chemotherapy: outcomes and safety of rapid desensitization in 413 cases. J Allergy Clin Immunol. 2008;122:574–80.
Syrigou E, Makrilia N, Koti I, Saif MW, Syrigos KN. Hypersensitivity reactions to antineoplastic agents: an overview. Anticancer Drugs. 2009;20:1–6.
Hong DI, Bankova L, Cahill KN, Kyin T, Castells MC. Allergy to monoclonal antibodies: cutting-edge desensitization methods for cutting-edge therapies. Expert Rev Clin Immunol. 2012;8:43–52.
Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0 [Internet]. US Department of Health and Human Service; [updated 2010 June 14; cited 2015 April 8]. Available from: http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf.
Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy. 2002;57:45–51.
Madrigal-Burgaleta R, Berges-Gimeno MP, Angel-Pereira D, Ferreiro-Monteagudo R, Guillen-Ponce C, Pueyo C, et al. Hypersensitivity and desensitization to antineoplastic agents: outcomes of 189 procedures with a new short protocol and novel diagnostic tools assessment. Allergy. 2013;68:853–61.
Brennan PJ, Bouza TR, Hsu FI, Sloane DE, Castells MC. Hypersensitivity reactions to mAbs: 105 desensitizations in 23 patients, from evaluation to treatment. J Allergy Clin Immunol. 2009;124:1259–66.
Lenz HJ. Management and preparedness for infusion and hypersensitivity reactions. Oncologist. 2007;12:601–9.
Vultaggio A, Maggi E, Matucci A. Immediate adverse reactions to biologicals: from pathogenic mechanisms to prophylactic management. Curr Opin Allergy Clin Immunol. 2011;11:262–8.
Funding
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Amorós-Reboredo, P., Sánchez-López, J., Bastida-Fernández, C. et al. Desensitization to rituximab in a multidisciplinary setting. Int J Clin Pharm 37, 744–748 (2015). https://doi.org/10.1007/s11096-015-0136-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-015-0136-x