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Treatment outcomes of rapid desensitisation protocols for chemotherapeutic agents and monoclonal antibodies following hypersensitivity reactions

Kuo, James C; Hawkins, Carolyn; Yip, Desmond

Description

Background: Hypersensitivity reactions (HSR) to chemotherapeutic agents and monoclonal antibodies are common and may limit further therapeutic options. Drug desensitisation aims to induce a temporary clinical unresponsiveness to drug antigens so the causative drugs of HSR can continue to be administered. Rapid desensitisation using standardised protocols has been conducted by the Department of Immunology at The Canberra Hospital for patients who developed HSR to chemotherapeutic agents and...[Show more]

dc.contributor.authorKuo, James C
dc.contributor.authorHawkins, Carolyn
dc.contributor.authorYip, Desmond
dc.date.accessioned2015-12-10T22:24:48Z
dc.identifier.issn1444-0903
dc.identifier.urihttp://hdl.handle.net/1885/53232
dc.description.abstractBackground: Hypersensitivity reactions (HSR) to chemotherapeutic agents and monoclonal antibodies are common and may limit further therapeutic options. Drug desensitisation aims to induce a temporary clinical unresponsiveness to drug antigens so the causative drugs of HSR can continue to be administered. Rapid desensitisation using standardised protocols has been conducted by the Department of Immunology at The Canberra Hospital for patients who developed HSR to chemotherapeutic agents and monoclonal antibodies. Aims: This retrospective audit reviewed the safety and efficacy of the desensitisation protocols used for patients across the Capital Region Cancer Service (CRCS). Methods: Patients across the CRCS who received rapid desensitisation were identified through a search of archived correspondence. Clinical files and pharmacy records were analysed to determine protocol safety and efficacy. Results: From June 2006 to July 2013, 13 patients underwent rapid desensitisations to oxaliplatin, carboplatin, docetaxel or rituximab. A total of 25 desensitisations was conducted with 21 (84%) achieving full target dose without inducing recurrent HSR. As a result, nine patients were successfully desensitised and continued to receive treatment without any further HSR. Desensitisation was aborted in three patients because of recurrence of HSR, which was not of a greater severity than the initial HSR. After successful desensitisation, seven patients were able to resume the regular protocols without requiring additional supervision. Conclusion: Rapid desensitisation to various chemotherapeutic agents and monoclonal antibodies with standardised protocols used across CRCS is safe and effective; it provides a feasible treatment option enabling continuation of effective regimens in the setting of HSR.
dc.publisherBlackwell Science Asia
dc.sourceInternal Medicine Journal
dc.subjectKeywords: antiinfective agent; carboplatin; cetirizine; dexamethasone; docetaxel; fexofenadine; hydrocortisone; loratadine; monoclonal antibody; oxaliplatin; prednisolone; promethazine; ranitidine; rituximab; adult; aged; article; clinical article; clinical protoco Chemotherapy; Desensitisation; Hypersensitivity reaction; Monoclonal antibody
dc.titleTreatment outcomes of rapid desensitisation protocols for chemotherapeutic agents and monoclonal antibodies following hypersensitivity reactions
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolumeOnline (published dates tbc)
dc.date.issued2013
local.identifier.absfor111200 - ONCOLOGY AND CARCINOGENESIS
local.identifier.absfor110300 - CLINICAL SCIENCES
local.identifier.absfor110700 - IMMUNOLOGY
local.identifier.ariespublicationu4971216xPUB268
local.type.statusPublished Version
local.contributor.affiliationKuo, James C, The Canberra Hospital
local.contributor.affiliationHawkins, Carolyn, College of Medicine, Biology and Environment, ANU
local.contributor.affiliationYip, Desmond, College of Medicine, Biology and Environment, ANU
local.description.embargo2037-12-31
local.bibliographicCitation.issue5
local.bibliographicCitation.startpage1
local.bibliographicCitation.lastpage21
local.identifier.doi10.1111/imj.12320
dc.date.updated2021-12-02T05:05:24Z
local.identifier.scopusID2-s2.0-84900017786
local.identifier.thomsonID000335569800004
CollectionsANU Research Publications

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