Comment on “Retrospective study of hypersensitivity reactions to chemotherapeutic agents in a thoracic oncology service”

2018 ◽  
Vol 44 (2) ◽  
pp. 335-336
Author(s):  
Amir Rezazadeh ◽  
Maryam Taghizadeh-Ghehi
Keyword(s):  
Retrospective Study ◽  
Chemotherapeutic Agents ◽  
Hypersensitivity Reactions ◽  
Oncology Service

Retrospective study of hypersensitivity reactions to chemotherapeutic agents in a thoracic oncology service

2017 ◽  
Vol 43 (3) ◽  
pp. 320-326 ◽  
Author(s):  
H. Capelle ◽  
C. Tummino ◽  
L. Greillier ◽  
M. Gouitaa ◽  
J. Birnbaum ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Chemotherapeutic Agents ◽  
Hypersensitivity Reactions ◽  
Oncology Service

Cetirizine versus diphenhydramine in the prevention of chemotherapy-related hypersensitivity reactions

2018 ◽  
Vol 25 (6) ◽  
pp. 1396-1401 ◽  
Author(s):  
Charis G Durham ◽  
Deepthi Thotakura ◽  
Lauren Sager ◽  
Jennifer Foster ◽  
Jon D Herrington
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Retrospective Study ◽  
Prospective Studies ◽  
Clinical Setting ◽  
Hypersensitivity Reactions ◽  
Efficacy And Safety ◽  
Infusion Reactions

Objective This study evaluated the role of cetirizine compared to diphenhydramine as premedications for patients receiving paclitaxel, cetuximab, and rituximab infusions. Historically, diphenhydramine has been linked with more sedation in comparison to cetirizine; however, it is unknown if cetirizine can replace diphenhydramine in the prevention of hypersensitivity reactions in patients receiving chemotherapy. Methods This is a retrospective study designed to assess infusion reactions occurring in patients receiving diphenhydramine or cetirizine premedication for rituximab, paclitaxel, or cetuximab therapies. Infusion reactions were defined as various symptoms such as flushing, itching, alterations in heart rate and blood pressure, and dyspnea plus the clinical setting of a concurrent or very recent infusion. Results A total of 207 patients were evaluated in this study with 83 patients receiving cetirizine and 124 diphenhydramine patients. Overall, the percentage of patients with at least one chemotherapy-related infusion event in the cetirizine group was 19.3% (95% CI 11.4–29.4) compared to diphenhydramine group 24.2% (95% CI 17.0–32.7), P = 0.40. Of the patients who received cetirizine and then experienced an event in the first cycle, 41.7% (95% CI 13.7–74.3) of the events were due to paclitaxel, 50.0% (95% CI 19.4–80.6) were due to rituximab, and 8.3% (95% CI 0.1–43.6) were due to cetuximab. Of the patients who received diphenhydramine and then experienced an event in the first cycle, 26.1% (95% CI 5.7–51.4) were due to paclitaxel, 73.9% (95% CI 48.6–94.3) were due to rituximab and none due to cetuximab. Conclusion Cetirizine appears to be a viable substitute for diphenhydramine for the prevention of infusions reactions with cetuximab, paclitaxel, and rituximab infusions in adults. Prospective studies are needed to determine the efficacy and safety of cetirizine compared with diphenhydramine in the prevention of chemotherapy-related infusion reactions.

scholarly journals Successful olaparib desensitization using a novel one-day protocol

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Rongbo Zhu ◽  
Stephen Welch ◽  
Hannah Roberts
Keyword(s):  
Adverse Reactions ◽  
Chemotherapeutic Agents ◽  
Hypersensitivity Reactions ◽  
Immediate Hypersensitivity ◽  
Case Presentation ◽  
Tablet Form ◽  
Desensitization Protocol ◽  
Ige Mediated ◽  
Loss Of Tolerance

Abstract Background Olaparib is a revolutionary treatment for patients with ovarian and breast cancer. Currently, there is no established 1-day drug desensitization protocol for patients with olaparib type-1 hypersensitivity reactions despite well documented IgE-mediated adverse reactions occurring with olaparib. Case presentation We report a 58-year-old female with immediate, reproducible IgE-mediated adverse reactions to olaparib tablets with implementation of a 1-day novel desensitization protocol to olaparib. Following desensitization, the patient was successfully transitioned from olaparib capsules to tablets with no loss of tolerance. Conclusions To our knowledge, this is the first reported case of successful olaparib desensitization using a novel 1-day desensitization protocol, and will contribute to drug allergy knowledge, in an area where robust data is lacking. This case demonstrates the important role for drug desensitization in patients with immediate hypersensitivity reactions to chemotherapeutic agents. Furthermore, as olaparib capsules are being phased out in favour of olaparib tablets, we provide a clear case that transitioning from capsule to tablet form did not cause a loss of tolerance.

scholarly journals Biomarkers Associated with Hypersensitivity Reactions to Chemotherapeutic Agents.

2020 ◽  
Vol 145 (2) ◽  
pp. AB100
Author(s):  
F. Javier Fernandez ◽  
Teodorikez Jimenez Rodriguez ◽  
Maria Ruano-Zaragoza ◽  
Purificación Gonzalez-Delgado ◽  
Victor Soriano-Gomis
Keyword(s):  
Chemotherapeutic Agents ◽  
Hypersensitivity Reactions

Clinical Outcome of B-Cell Chronic Lymphocytic Leukemia Following Alemtuzumab Therapy: Retrospective Study within Various Cytogenetic Risk Categories

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3164-3164
Author(s):  
Michael Fiegl ◽  
Martin Erdel ◽  
Inge Tinhofer ◽  
Georg Hopfinger ◽  
Karin Eigenberger ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Chronic Lymphocytic Leukemia ◽  
B Cell ◽  
Chemotherapeutic Agents ◽  
Lymphocytic Leukemia ◽  
Cox Regression Analysis ◽  
Trisomy 12 ◽  
11Q Deletion ◽  
Cell Chronic Lymphocytic Leukemia ◽  
13Q Deletion

Abstract B-cell chronic lymphocytic leukemia (CLL) with 17p deletion responds poorly to chemotherapeutic agents. This retrospective study evaluated the benefit of alemtuzumab monotherapy in unselected patients with advanced CLL, categorized by cytogenetic profile. Methods: This is the largest data base with efficacy analysis of alemtuzumab in CLL stratified according to cytogenetics. Detailed data analysis was done in 138 CLL patients, in whom cytogenetic analysis was performed by FISH using the standard CLL analysis categorized according to Doehner et al. (N Engl J Med343, 1910; 2000). Responses were evaluated according to the NCI criteria; progression-free survival (PFS) and overall survival (OS) were also assessed. Results: 73% of the patients were male. At start of alemtuzumab therapy, the median age was 64 years (range, 46–92); 12% were in Rai stage I, 18% in stage II, 20% in stage III, and 50% in stage IV. The median number of two prior therapies was 2 (range, 0–10); of the patients who received prior fludarabine (F) (n=113), 70% were F-refratory, 25% sensitive, and in 5% this was unknown. 30% and 17% of patients had bulky lymphadenopathy (>5 cm) and giant splenomegaly (>20 cm), respectively. Cytogenetic abnormalities were as follows: 13q deletion 14%; trisomy 12, 12%, 11q deletion 20%; 17p deletion, 33%, none of these, 22%. The overall response rate (ORR) was 38% in the total cohort. ORR was 53%, 56%, 21%, and 44% in the subgroup of 13q deletion, trisomy 12, 11q deletion, and 17p deletion, respectively; patients without any of these abnormalities had an ORR of 27%. From start of alemtuzumab, median PFS and OS for the whole cohort was 6.9 months and 30 months, respectively. Notably, PFS and OS in 17p deletion patients was 7.1 months and 19.1 months, respectively, an encouraging outcome when considering the unfavourable risk profile in these patients. In 17p deletion patients, response was remarkable also in disease involved lymph nodes (78%). Patients with F-resistant disease and 17p deletion, an extraordinarily poor prognostic group (n=25), had encouraging ORR, PFS, and OS rates (28%; 7.2 months; and 19.1 months, respectively), which did not differ from those in F-resistant patients with good risk cytogenetics. In a multivariate Cox regression analysis, independent risk factors for shorter OS were anemia (hazard ratio [HR] = 2.48; 95% CI, 1.50–4.11; P <.001), ≥3 of prior lines of therapy (HR = 2.00; 95% CI, 1.24–3.24, P =.005), and poor risk cytogenetics ([17p deletion and 11q deletion], HR = 2.23; 95% CI 1.35–3.69, P =.002). Conclusion: Alemtuzumab was effective in CLL across all cytogenetic categories evaluated. In patients with favorable cytogenetics, we observed that alemtuzumab is a highly effective therapy even when conventional chemotherapy has failed. Patients with 17p deletion achieved quite favorable ORR and OS upon alemtuzumab. Thus, the 17p deletion group can often be shifted to an “intermediate” risk CLL, and responding patients are frequently re-treated with alemtuzumab.

Immediate reaction to ibrutinib amenable to oral desensitization

2021 ◽  
pp. 107815522110046
Author(s):  
Neelam A Phadke ◽  
Samantha O Luk ◽  
Ephraim P Hochberg ◽  
Aleena Banerji
Keyword(s):  
Maculopapular Rash ◽  
Chemotherapeutic Agents ◽  
Lymphocytic Leukemia ◽  
Hypersensitivity Reactions ◽  
First Line ◽  
Management Guidelines ◽  
Cutaneous Hypersensitivity ◽  
Ige Mediated ◽  
To Receive ◽  
Oral Desensitization

Introduction Although up to half of patients receiving chemotherapeutic agents develop hypersensitivity reactions to the same, desensitization protocols can induce temporary tolerance to allow patients to continue to receive first-line treatment. Approximately 25% of patients develop cutaneous hypersensitivity reactions to ibrutinib, but there are no published management guidelines. Case report We describe the case of a 71-year-old woman with chronic lymphocytic leukemia who developed a delayed maculopapular rash with lip tingling and swelling following ibrutinib therapy. Management and outcome We performed a novel 11-step desensitization procedure to ibrutinib allowing us to successfully induce tolerance against IgE-mediated symptoms in this patient. Discussion As indications for ibrutinib use expand and more patients present with IgE-mediated symptoms, we expect that this protocol will provide benefit for many such patients.

Skin tests for the exploration of hypersensitivity reactions associated with iodinated contrast media

2021 ◽  
Vol 16 ◽  
Author(s):  
Ahmed Zaiem ◽  
Syrine Ben Hammamia ◽  
Fares Ben Salem ◽  
Ons Charfi ◽  
Imen Aouinti ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hypersensitivity Reaction ◽  
Contrast Media ◽  
Skin Testing ◽  
Skin Tests ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast ◽  
Intradermal Tests ◽  
The One

Background: Iodinated contrast media (ICM) are responsible for multiple side effects, especially hypersensitivity reactions. These reactions can either be authentic allergies, or non-allergic hypersensitivity reactions. Skin tests (prick and intradermal tests) are simple to perform and can be of great help, especially if the ICM need to be re-used. The aim of the study was to assess the characteristics of the patients in whom skin tests were performed, and the results of these tests. Methods: This is a retrospective study from June 2014 to June 2019. All included patients had at least one episode of hypersensitivity reaction to ICM and underwent skin tests. Results : We included 35 patients aged 18 to 85 years. The iopromide was the most implicated ICM. The reactions were mainly cutaneous (n=30) and immediate (n=27). The skin tests were negative, except for two patients. The reuse of ICM occured in 11 patients: 9 with an ICM other than the one suspected and two patients with the same ICM. Among these patients, 5 did not have any premedication. Two of them had a second hypersensitivity reaction, the first with another ICM and the second with the same ICM. Conclusion: One of the main pillars of allergic exploration is ICM skin testing, not only to prevent recurrence, but also to allow patients to benefit from ICM reuse, which are sometimes essential.

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