Allergy Unit Zieglerspital, Clinic of Internal Medicine, Spital Netz Bern AG, Bern, Switzerland.
Division of Allergology, University Clinic of Rheumatology, Immunology & Allergology, Inselspital/University Hospital Bern, Switzerland.
J Investig Allergol Clin Immunol. 2017;27(6):370-377. doi: 10.18176/jiaci.0184. Epub 2017 Jul 4.
Malignancies are often considered a contraindication for allergen-specific immunotherapy. Consequently, patients with severe Hymenoptera venom allergy and cancer require specific care. The aim of this retrospective study was to assess patients with Hymenoptera venom allergy and cancer undergoing venom immunotherapy (VIT).
The study population comprised all patients referred for evaluation of Hymenoptera venom allergy or for a routine check-up during VIT from January 1, 2004 to December 31, 2008.
Of the patients assessed, 2% (51 of 2594) had a documented Hymenoptera venom allergy and cancer (25 female, 26 male; mean age 58 years). Of these, 42 patients received VIT (82%): 25 patients had a previously diagnosed malignancy, 16 were diagnosed with malignancy during VIT, and 1 patient was diagnosed with cancer after completion of VIT. The most frequent type of tumor was breast cancer in female patients (60%) and prostate cancer in male patients (39%). Systemic allergic reactions during VIT were recorded in 7% of patients. A total of 19 patients experienced a field sting or underwent a sting challenge test during VIT: 95% tolerated the sting well. VIT was halted definitively in 9 patients (new diagnosis of cancer in 7 patients, reactivation of cancer in 1, and progressive polyneuropathy in 1).
The effectiveness and adverse effects of VIT in patients with Hymenoptera venom allergy and cancer in remission are comparable to those of patients without malignancy. Our findings show that patients with Hymenoptera venom allergy and cancer are eligible for VIT.
恶性肿瘤通常被认为是变应原特异性免疫治疗的禁忌症。因此，患有严重蜂类毒液过敏和癌症的患者需要特殊的护理。本回顾性研究旨在评估接受蜂类毒液免疫治疗（VIT）的蜂类毒液过敏和癌症患者。
研究人群包括所有因评估蜂类毒液过敏或在 2004 年 1 月 1 日至 2008 年 12 月 31 日期间接受常规 VIT 检查而就诊的患者。
在评估的患者中，有 2%（2594 例中有 51 例）记录有蜂类毒液过敏和癌症（25 例女性，26 例男性；平均年龄 58 岁）。其中，42 例患者接受了 VIT（82%）：25 例患者先前诊断患有恶性肿瘤，16 例在 VIT 期间诊断患有恶性肿瘤，1 例在完成 VIT 后诊断患有癌症。女性患者最常见的肿瘤类型是乳腺癌（60%），男性患者最常见的肿瘤类型是前列腺癌（39%）。在 VIT 期间记录到 7%的患者发生全身性过敏反应。共有 19 例患者在 VIT 期间经历了野外蜇伤或接受了蜇伤挑战试验：95%的患者蜇伤后反应良好。共有 9 例患者（7 例新诊断为癌症，1 例癌症复发，1 例进行性多神经病）最终停止了 VIT。
在缓解期的蜂类毒液过敏和癌症患者中，VIT 的有效性和不良反应与无恶性肿瘤患者相似。我们的研究结果表明，蜂类毒液过敏和癌症患者有资格接受 VIT。
