Mahidol University, Ramathibodi Hospital, Division of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine, Rama 6th Road, Phyathai, Bangkok 10400, Thailand.
Expert Opin Drug Saf. 2010 Jan;9(1):39-53. doi: 10.1517/14740330903446936.
The incidence of hypersensitivity reactions (HSRs) to chemotherapy agents has increased because of increasing number of cancer survivors are exposed to repeated courses of sensitizing agents. Replacement with an alternative chemotherapy regimen is often limited by tumor sensitivity. Rapid desensitization offers an effective mean to allow continuation of the treatment to which patients have presented HSRs.
We review the methods, outcome and safety of the rapid desensitization protocol developed at Brigham and Women's Hospital, Harvard Medical School Affiliate, based on our recent publication "'Hypersensitivity reactions to chemotherapy: outcome and safety of rapid desensitization in 413 cases". Literature search was conducted through Medline (from January 1976 to September 2009), using PubMed.
The article will give insight to clinical manifestations of immediate HSR to various chemotherapy agents and their presumably different immunopathomechanism. Risk assessment, including skin testing in those presented HSRs to platins and details on rapid desensitization process and its pitfalls will be discussed.
Standa"rd protocol of rapid desensitization, administering under multidisciplinary team approach, is safe and effective in overcoming immediate HSRs to platins, taxanes, doxorubicin and rituximab via both intravenous and intraperitoneal routes.
由于越来越多的癌症幸存者接触到反复的致敏药物，化疗药物过敏反应（HSR）的发生率有所增加。由于肿瘤的敏感性，用替代化疗方案替代往往受到限制。快速脱敏提供了一种有效的方法，允许继续对患者出现 HSR 的治疗。
我们根据我们最近发表的“化疗药物过敏反应：413 例快速脱敏的结果和安全性”，综述了哈佛医学院附属布莱根妇女医院开发的快速脱敏方案的方法、结果和安全性。通过 Medline（从 1976 年 1 月至 2009 年 9 月）进行文献检索，使用 PubMed。
本文将深入了解各种化疗药物的即刻 HSR 的临床表现及其可能不同的免疫发病机制。将讨论风险评估，包括对铂类和紫杉烷类药物 HSR 患者进行皮肤测试，以及快速脱敏过程及其陷阱的详细信息。
标准的快速脱敏方案，通过多学科团队的方法进行管理，通过静脉内和腹腔内途径，在克服铂类、紫杉烷类、多柔比星和利妥昔单抗的即刻 HSR 方面是安全有效的。
