ABSTRACT
BACKGROUND: Desensitization has been used for some decades to treat patients with the allergenic drug when an alternative drug with similar efficacy and safety is not available. We present the results from a series of oncology patients desensitized at our hospital during the last 2 years. OBJECTIVE: To assess the efficacy of a new desensitization protocol in patients allergic to chemotherapy drugs. METHODS: We performed an observational retrospective study of 11 women (6 breast cancer and 5 ovarian cancer) who underwent our desensitization protocol. Four patients had immediate reactions to carboplatin, 3 to docetaxel, 3 to paclitaxel, and 1 to both docetaxel and paclitaxel. Premedication was administered in all cases. A 5-step protocol based on 5 different dilutions of the drugs was used. RESULTS: We performed 39 desensitization procedures: 14 to carboplatin, 3 to oxaliplatin, 16 to docetaxel, and 6 to paclitaxel. Eight patients tolerated the full dose in 36 procedures. One patient suffered an anaphylactic reaction to carboplatin that reverted with treatment. One patient had dyspnea after a paclitaxel cycle. One patient experienced dyspnea due to chronic pulmonary thromboembolism related to her disease. CONCLUSION: Desensitization is a useful procedure in patients who are allergic to their chemotherapy agents.
Subject(s)
Antineoplastic Agents/immunology , Desensitization, Immunologic/methods , Adult , Aged , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/immunology , Drug Hypersensitivity/drug therapy , Female , Humans , Middle Aged , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/immunology , Retrospective Studies , Treatment OutcomeSubject(s)
Echinococcosis, Hepatic/diagnosis , Echinococcus/pathogenicity , Hepatectomy , Osteoporosis/diagnosis , Aged , Angioedema , Animals , Antibodies, Helminth/blood , Diagnosis, Differential , Disease Progression , Disease Vectors , Disease-Free Survival , Dogs , Echinococcosis, Hepatic/complications , Echinococcosis, Hepatic/physiopathology , Echinococcosis, Hepatic/therapy , Environmental Exposure/adverse effects , Female , Humans , Osteoporosis/complications , Osteoporosis/physiopathology , Osteoporosis/therapy , Recurrence , UrticariaSubject(s)
Cold Temperature/adverse effects , Drug Hypersensitivity/diagnosis , Operating Rooms , Urticaria/diagnosis , Aged, 80 and over , Clinical Protocols , Diagnosis, Differential , Drug Hypersensitivity/complications , Drug Hypersensitivity/drug therapy , Drug Hypersensitivity/physiopathology , Erythema , Histamine Antagonists/therapeutic use , Humans , Male , Penicillins/adverse effects , Pruritus , Sodium Chloride/chemistry , Urticaria/etiology , Urticaria/physiopathology , Urticaria/prevention & controlABSTRACT
BACKGROUND: We have demonstrated previously mast cell histamine release upon incubation with chronic urticaria (CU) sera, presumably by degranulation. OBJECTIVE: To explore total and mature tryptase in order to assess whether any increase in total tryptase levels is due in part to mast cell degranulation or to mast cell burden. We also wanted to explore differences between the autoimmune groups called idiopathic (serum unable to activate basophils), and to correlate total and mature tryptase levels with different urticaria features. METHODS: We measured total and mature tryptase serum levels in 81 CU patients, 16 atopic donors and 21 healthy control sera. We assessed autoimmunity by measuring the CD63 expression in normal basophil donors upon incubation with CU sera. RESULTS: We found significantly higher levels of total tryptase in the sera of CU patients (6.6 ±4.1 µg/L) than in sera from healthy non-atopic subjects (4.4 ±2.8 µg/L) and from atopic subjects (4.5 ±1.7 µg/L). Mature tryptase levels were undetectable (<1 ng/mL). Total tryptase levels in the autoimmune urticaria group were significantly higher (9.8 ±5.4 µg/L) than the idiopathic urticaria group (4.4 ±2.2 µg/L). A significant difference in total tryptase was found between symptomatic patients (7.3 ±4.1 µg/L) compared with asymptomatic ones (5.7 ±4.1 µg/L) at the time of venesection. No difference was found in mature tryptase levels either. CONCLUSION: Total elevated tryptase levels are not accompanied by an elevated mature tryptase levels, as might be expected if the serum levels reflected mast cell degranulation.
