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首页> 外文期刊>Clinical and Translational Allergy >Rapid desensitization in delayed hypersensitivity reactions to chemotherapy and monoclonal antibodies
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Rapid desensitization in delayed hypersensitivity reactions to chemotherapy and monoclonal antibodies

机译：对化疗和单克隆抗体的迟发型超敏反应中的快速脱敏

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BackgroundDrug desensitization is the induction of temporary clinicalunresponsiveness to drug antigens to which patients havepresented severe hypersensitivity reactions (HSR). Rapiddesensitization in patients suffering immediate hypersensitivityreactions with chemotherapeutic agents and monoclonalantibodies have been widely described and haveshown to be successful. Non-immediate hypersensitivityreactions with other drugs have usually required desensitizationwith several days’ protocols to achieve total doses.MethodForty three desensitization procedures were performedin 6 patients with a 12-13 step, 6-hour protocol. Allpatients had developed a delayed maculopapular rashwith the use of chemotherapeutic and/or biologicalagents. Four patients were pretreated with corticosteroids,paracetamol and antihistamines before each desensitizationprocedure.ResultsAll the 43 desensitizations undertaken were successfullycompleted (Temozolamide 25, Bendamustine 4, Rituximab4, Infliximab 5 and Gemcitabina 5). We observedHSR during 11 (25%) of desensitizations, including 5inmediate exantema, 3 delayed local macular exantemaand 3 delayed maculopapular lesions. Four patients weretreated with corticosteroids and anti-histamines afterthe desensitization protocol to avoid more delayed HSR.ConclusionsRapid desensitization protocols are safe and effective ingetting over delayed HSR to chemotherapeutic andmonoclonal antibodies and allow patients with severediseases to continue their treatment.
机译：背景技术药物脱敏是对患者表现出严重超敏反应（HSR）的药物抗原产生暂时的临床无反应性。患有与化学治疗剂和单克隆抗体立即发生超敏反应的患者中的快速脱敏已被广泛描述并已证明是成功的。与其他药物的非立即超敏反应通常需要经过几天的方案才能脱敏，以达到总剂量。方法对6例12-13步，6小时方案的患者进行了43次脱敏程序。所有患者均使用化学治疗和/或生物制剂发展为延迟性斑丘疹。 4例患者在每次脱敏之前均接受了皮质类固醇，扑热息痛和抗组胺药预处理。结果成功完成了43例脱敏治疗（替莫唑胺25，苯达莫司汀4，利妥昔单抗4，英夫利昔单抗5和吉西他滨5）。我们在11例（25％）的脱敏过程中观察到了HSR，包括5次中度充血，3次局部黄斑部充血和3次迟发性黄斑病变。四例患者在脱敏方案后接受了皮质类固醇和抗组胺药治疗，以避免更多的HSR延迟。结论快速脱敏方案可安全有效地克服延迟的HSR对化学疗法和单克隆抗体的影响，并允许患有严重疾病的患者继续治疗。

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