Desensitization for hypersensitivity reactions related to chemotherapy

), 정재우 ( Jae-woo Jung

doi:10.4168/aard.2020.8.3.105

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…Anticancer drugs are administered repeatedly at regular intervals and are prone to sensitization, and the incidence of hypersensitivity reactions varies from 1% to 80% depending on the type of drug [32] . In the case of anticancer drugs, hypersensitivity reactions to the drug as well as cytotoxicity caused by the drug itself are important causes of treatment discontinuation.…”

Section: Anti-cancer Drugsmentioning

confidence: 99%

“…Caused by progressive sensitization due to repeated drug exposure, the first hypersensitivity reaction usually occurs after 7-9 cycles of administration, especially when the drug is reused after a period of inactivity [32,37] . In addition, cross-reactions between platinum-based drugs can occur, so caution is advised when changing formulations within a platinum-based drug.…”

Section: Anti-cancer Drugsmentioning

confidence: 99%

“…To overcome these disadvantages, singleconcentration protocols have been proposed that involve dilution to a single concentration followed by a stepwise increase in the dosing rate at regular intervals (Table 2) [44,45] . To date, desensitization therapy using single-concentration protocols has been successfully performed for a variety of agents, including platinumand taxane-based anticancer drugs and monoclonal antibodies [32,46] . Compared to the step-dilution protocol, there was no statistically significant difference in the completion rate of desensitization and the incidence 2020 Volume 5, Issue 1 Desensitization for the Prevention of Drug Hypersensitivity -7-of extrapolation reactions; rather, the time required for desensitization preparation was significantly reduced with the single-concentration protocol.…”

Section: Anti-cancer Drugsmentioning

confidence: 99%

See 2 more Smart Citations

Desensitization for the Prevention of Drug Hypersensitivity

Yun,

Jeong,

Kang

2023

jmds

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Drug desensitization is a treatment strategy for patients with hypersensitivity to essential drugs without alternatives. The gradual increase in the drug dosage from low doses to therapeutic levels induces a transient immune tolerance to the culprit drug. Although desensitization has traditionally been recommended for IgE-mediated immediate hypersensitivity, this indication has recently been expanded to include non-IgE-mediated immediate responses, nonimmunological responses, and T-cell mediated delayed hypersensitivity reactions. Although the exact mechanism behind desensitization remains unclear, the process is thought to attenuate various intracellular signals in target cells through the high-affinity IgE receptor (FcɛRI) internalization, alteration in signaling pathways in mast cells and basophils, reduction in Ca2+ influx, and production of anti-drug IgG4 blocking antibody. Desensitization can be used for the safe administration of anti-neoplastic agents, antibiotics, aspirin, and nonsteroidal anti-inflammatory drugs. Various desensitization protocols have been proposed for each drug. The optimization of drug concentration, target dosage, administration interval, and route of administration is key to successful desensitization. In addition, the desensitization protocol should be individualized for each patient with consideration of the severity of the initial hypersensitivity response, the characteristics of the culprit drug, and the nature of the breakthrough reactions.

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Section: Anti-cancer Drugsmentioning

confidence: 99%

Section: Anti-cancer Drugsmentioning

confidence: 99%