User login
Background Hypersensitivity reactions to chemotherapy agents occur with relatively high frequency with some of the most widely used chemotherapeutic drug classes. Desensitization using a standard 12-step protocol has been successful, but takes about 6.5 hours. Limited studies have shown that a faster protocol may also be safe.
Objective To determine when desensitization could be safely speeded up.
Methods Patients with documented HSRs (24 patients) were desensitized initially with the standard 12-step protocol for 1 or 2 treatments, for a total of 180 desensitizations. Those patients who had negative skin testing and who tolerated the desensitizations were switched to the more rapid desensitization protocol (16 patients).
Results All 16 patients were successfully desensitized, having received the full dose of their chemotherapy. Eight patients were not advanced to the rapid protocol because they had reactions during initial desensitizations or they had a positive skin test; all of them were successfully desensitized using the 12-step protocol at the slower rate of infusion. These data present criteria for defining which patients may be safely transitioned to a rapid desensitization protocol.
Limitation Most of the patients in the study (21 of 24) were women.
Conclusions Patients with HSRs to chemotherapy agents, who tolerate an initial 12-step desensitization and have a negative skin test, can be advanced to a more rapid protocol. It is likely that patients with HSRs to the taxanes can be started on the more rapid protocol without starting on the 12-step protocol.
*Click on the PDF icon at the top of this introduction to read the full article.
Background Hypersensitivity reactions to chemotherapy agents occur with relatively high frequency with some of the most widely used chemotherapeutic drug classes. Desensitization using a standard 12-step protocol has been successful, but takes about 6.5 hours. Limited studies have shown that a faster protocol may also be safe.
Objective To determine when desensitization could be safely speeded up.
Methods Patients with documented HSRs (24 patients) were desensitized initially with the standard 12-step protocol for 1 or 2 treatments, for a total of 180 desensitizations. Those patients who had negative skin testing and who tolerated the desensitizations were switched to the more rapid desensitization protocol (16 patients).
Results All 16 patients were successfully desensitized, having received the full dose of their chemotherapy. Eight patients were not advanced to the rapid protocol because they had reactions during initial desensitizations or they had a positive skin test; all of them were successfully desensitized using the 12-step protocol at the slower rate of infusion. These data present criteria for defining which patients may be safely transitioned to a rapid desensitization protocol.
Limitation Most of the patients in the study (21 of 24) were women.
Conclusions Patients with HSRs to chemotherapy agents, who tolerate an initial 12-step desensitization and have a negative skin test, can be advanced to a more rapid protocol. It is likely that patients with HSRs to the taxanes can be started on the more rapid protocol without starting on the 12-step protocol.
*Click on the PDF icon at the top of this introduction to read the full article.
Background Hypersensitivity reactions to chemotherapy agents occur with relatively high frequency with some of the most widely used chemotherapeutic drug classes. Desensitization using a standard 12-step protocol has been successful, but takes about 6.5 hours. Limited studies have shown that a faster protocol may also be safe.
Objective To determine when desensitization could be safely speeded up.
Methods Patients with documented HSRs (24 patients) were desensitized initially with the standard 12-step protocol for 1 or 2 treatments, for a total of 180 desensitizations. Those patients who had negative skin testing and who tolerated the desensitizations were switched to the more rapid desensitization protocol (16 patients).
Results All 16 patients were successfully desensitized, having received the full dose of their chemotherapy. Eight patients were not advanced to the rapid protocol because they had reactions during initial desensitizations or they had a positive skin test; all of them were successfully desensitized using the 12-step protocol at the slower rate of infusion. These data present criteria for defining which patients may be safely transitioned to a rapid desensitization protocol.
Limitation Most of the patients in the study (21 of 24) were women.
Conclusions Patients with HSRs to chemotherapy agents, who tolerate an initial 12-step desensitization and have a negative skin test, can be advanced to a more rapid protocol. It is likely that patients with HSRs to the taxanes can be started on the more rapid protocol without starting on the 12-step protocol.
*Click on the PDF icon at the top of this introduction to read the full article.