Oncology Pharmacy Department, Hospital Universitario Lucus Augusti, Lugo, Spain.
Pharmacy Department, Hospital Universitario Lucus Augusti, Lugo, Spain.
Ann Pharmacother. 2023 Jan;57(1):55-61. doi: 10.1177/10600280221093594. Epub 2022 May 14.
Hypersensitive reactions (HSRs) often require that the provoking medication be discontinued but chemotherapeutic drugs are often essential for the treatment of the disease. Rapid drug desensitization is a procedure that induces temporary tolerance to the drug allowing continuation of treatment in patients who have presented HSRs. Most of the desensitization protocols use 3 bags with sequential dilutions of the drug, which are infused in gradual steps. However, it has not been sufficiently investigated whether dilution is essential for successful desensitization.
The objective of this study was to evaluate the efficacy and safety of a new one-bag desensitization protocol which uses a single solution of 1 mg/mL throughout the procedure allowing to reduce time and simplifying the desensitization procedure.
Retrospective observational study was carried out in adult patients with HSRs to chemotherapy agents who received a new nondilution one-bag desensitization protocol between 2016 and 2021.
A total of 130 desensitization procedures with an undiluted one-bag protocol were performed on 17 patients with HSRs to chemotherapy. One hundred and seven (82.3%) were for desensitization to CBDCA, 15 (11.5%) for oxaliplatin, 4 (3.1%) for paclitaxel and 4 (3.1%) for brentuximab. All of the 130 procedures were successfully accomplished, and all patients could receive their target dose. No breakthrough reactions (BTRs) occurred in 77% (100/130) of desensitizations, and only mild reactions (grade 1) with skin symptoms were observed in 23% (30/130) of desensitizations.
The undiluted one-bag desensitization protocol was safe and effective and has been adopted as the standard of care at our institution in treating patients with HSRs to chemotherapeutic drugs as it requires less time and simplifies the desensitization procedure, optimizing risk management.
超敏反应（HSR）常需要停用诱发药物，但化疗药物通常是治疗疾病的必要药物。快速药物脱敏是一种诱导对药物暂时耐受的程序，允许在出现 HSR 的患者中继续治疗。大多数脱敏方案使用 3 袋连续稀释的药物，逐渐输注。然而，尚未充分研究稀释是否对成功脱敏至关重要。
本研究旨在评估一种新的单袋脱敏方案的疗效和安全性，该方案在整个过程中使用 1mg/ml 的单一溶液，从而减少时间并简化脱敏程序。
对 2016 年至 2021 年间接受新的非稀释单袋脱敏方案的化疗药物 HSR 成年患者进行回顾性观察性研究。
共对 17 例 HSR 患者进行了 130 例未稀释单袋方案脱敏，其中 107 例（82.3%）为 CBDCA 脱敏，15 例（11.5%）为奥沙利铂脱敏，4 例（3.1%）为紫杉醇脱敏，4 例（3.1%）为 brentuximab 脱敏。所有 130 例脱敏均成功完成，所有患者均可接受目标剂量。77%（100/130）的脱敏未出现突破性反应（BTR），仅 23%（30/130）的脱敏出现皮肤症状的轻度反应（1 级）。
未稀释的单袋脱敏方案安全有效，已被我们机构采用为治疗化疗药物 HSR 患者的标准治疗方法，因为它需要更少的时间并简化脱敏程序，从而优化风险管理。
