Hypersensitivity Reactions to Cancer Chemotherapy: Practical Recommendations of ARADyAL for Diagnosis and Desensitization

J Investig Allergol Clin Immunol. 2021 Oct 25;31(5):364-384. doi: 10.18176/jiaci.0712. Epub 2021 May 28.

Abstract

Rapid drug desensitization has enabled first-line therapies in patients with drug hypersensitivity reactions to chemotherapeutic drugs including monoclonal antibodies. Desensitization is a safe and highly effective procedure, not only for IgE-mediated reactions, but also for those mediated by non-IgE mechanisms. The likelihood of breakthrough reactions during desensitization is low, and most are mild; in fact, moderate-to-severe reactions are infrequent. In this document, 16 allergy departments belonging to the Spanish research network ARADyAL present a review of the available scientific evidence and provide general guidelines for the diagnosis and management of drug hypersensitivity reactions to chemotherapeutic drugs and monoclonal antibodies. Emphasis is placed on the desensitization procedure.

Keywords: Chemotherapy; Desensitization; Drug allergy; Drug challenge; Drug hypersensitivity; Monoclonal antibodies.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents, Immunological* / therapeutic use
  • Desensitization, Immunologic
  • Drug Hypersensitivity* / drug therapy
  • Drug Hypersensitivity* / therapy
  • Humans
  • Neoplasms* / drug therapy

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological