Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Turkey.
Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine, Turkey.
Ann Allergy Asthma Immunol. 2019 Oct;123(4):394-397. doi: 10.1016/j.anai.2019.07.031. Epub 2019 Aug 7.
Desensitization in immediate-type hypersensitivity reactions (HRs) caused by chemotherapeutics is well described and standardized for many drugs. However, there are no standardized protocols in non-immediate HRs.
To evaluate the effectiveness of a 16-day desensitization protocol in the non-immediate HRs induced by lenalidomide.
According to our previously published slow desensitization protocol, we desensitized patients who had experienced non-immediate HRs attributable to lenalidomide. The protocol was started with the 1/100 of the daily-prescribed dose in milligrams of the culprit drug; then the doses were slowly increased to complete the procedure in 16 days. Demographic and clinical features of the patients were further appraised.
Ten patients (mean age was 64.7 ± 10.8 years; 7 male) were successfully desensitized to lenalidomide. The mean reaction time was 7.3 ± 3.9 days in the history, and the reaction types were delayed urticaria (n = 4), eczematous rash (n = 3), and maculopapular eruptions (n = 3). The desensitization was successfully completed in 16 days in 9 patients. In 1 patient, maculopapular eruptions developed on the 11th day, and the patient was treated with corticosteroids. We repeated the previous tolerated dose longer and completed with a slower dose increasement, and the targeted dose was achieved in 35 days.
The 16-day desensitization protocol seemed to be safe and effective in the non-immediate type drug HRs caused by lenalidomide.
许多药物的即时型超敏反应 (HR) 所致的脱敏作用已得到很好的描述和标准化，但非即时型 HR 则没有标准化的方案。
评估 16 天脱敏方案在来那度胺引起的非即时型 HR 中的有效性。
根据我们之前发表的缓慢脱敏方案，对因来那度胺而发生非即时型 HR 的患者进行脱敏。方案从 1/100 日剂量的起始剂量开始，以毫克计，然后缓慢增加剂量，在 16 天内完成整个过程。进一步评估患者的人口统计学和临床特征。
10 例患者（平均年龄为 64.7 ± 10.8 岁；7 例男性）成功地对来那度胺脱敏。在病史中，平均反应时间为 7.3 ± 3.9 天，反应类型为迟发性荨麻疹（n=4）、湿疹样皮疹（n=3）和斑丘疹性皮疹（n=3）。9 例患者在 16 天内成功完成脱敏。1 例患者在第 11 天出现斑丘疹性皮疹，并用皮质类固醇治疗。我们重复之前耐受的剂量并以更慢的剂量递增完成，在 35 天内达到目标剂量。
16 天的脱敏方案似乎对来那度胺引起的非即时型药物 HR 是安全有效的。
