Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 850 Boylston Street Suite 540, Chestnut Hill, MA, 02467, USA,
Curr Allergy Asthma Rep. 2014 Aug;14(8):453. doi: 10.1007/s11882-014-0453-5.
Acute infusion reactions to both chemotherapeutic agents and humanized monoclonal antibodies can occur, which may limit therapeutic options for treatment of malignancies and chronic inflammatory diseases. Many of these acute infusion reactions are consistent with a type I hypersensitivity reaction, including anaphylaxis. If a patient experiences a significant acute infusion reaction, often the recommendation is to discontinue the medication and find an alternative agent. However, the "second-line" agent may be more toxic or inferior. If the reaction is likely a type I or type IV hypersensitivity reaction, one option is to undergo desensitization to the offending drug. Drug desensitization is the process of readministering a needed drug in incremental doses over hours or days until a full therapeutic dose is tolerated. This article will review the current literature on indications and outcomes for drug desensitization in the management of allergy to either chemotherapeutic agents or monoclonal antibodies.
急性输注反应可发生于化疗药物和人源化单克隆抗体，这可能会限制恶性肿瘤和慢性炎症性疾病的治疗选择。许多这类急性输注反应与 I 型超敏反应一致，包括过敏反应。如果患者出现严重的急性输注反应，通常建议停用药物并寻找替代药物。然而，“二线”药物可能毒性更大或疗效更差。如果反应可能是 I 型或 IV 型超敏反应，则一种选择是进行脱敏治疗。药物脱敏是指在数小时或数天内逐渐增加剂量重新给予所需药物，直到耐受全治疗剂量。本文将回顾药物脱敏治疗化疗药物或单克隆抗体过敏的适应证和结局的现有文献。
