The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion Center
BackgroundHypersensitivity reactions to chemotherapy disrupt treatment schedules and compromise patient outcomes. Rapid Drug Desensitization (RDD) enables patients to tolerate future treatments after an allergy workup. However, Same-Day Desensitization (SDD) is a novel approach that capitalizes on R...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Allergy |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/falgy.2024.1479469/full |
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| author | Julián Borrás Cuartero Maria Cruz Torres Górriz Maria Cruz Torres Górriz Maria Cruz Torres Górriz Cristina Isabel Stein Coronado Cristina Isabel Stein Coronado Adrián Germán Sánchez Adrián Germán Sánchez Cristina Giovanna Pesántez Méndez Cristina Giovanna Pesántez Méndez Maria Dolores Latorre Ibáñez Ernesto Enrique Ernesto Enrique Ernesto Enrique |
| author_facet | Julián Borrás Cuartero Maria Cruz Torres Górriz Maria Cruz Torres Górriz Maria Cruz Torres Górriz Cristina Isabel Stein Coronado Cristina Isabel Stein Coronado Adrián Germán Sánchez Adrián Germán Sánchez Cristina Giovanna Pesántez Méndez Cristina Giovanna Pesántez Méndez Maria Dolores Latorre Ibáñez Ernesto Enrique Ernesto Enrique Ernesto Enrique |
| author_sort | Julián Borrás Cuartero |
| collection | DOAJ |
| description | BackgroundHypersensitivity reactions to chemotherapy disrupt treatment schedules and compromise patient outcomes. Rapid Drug Desensitization (RDD) enables patients to tolerate future treatments after an allergy workup. However, Same-Day Desensitization (SDD) is a novel approach that capitalizes on RDD to allow the continuation of chemotherapy on the same day as the index reaction, preventing treatment delays.ObjectiveTo evaluate the safety and efficacy of SDD in managing hypersensitivity reactions during chemotherapy and emphasize the essential role of allergists in the Oncology Infusion Center (OIC) for accurate drugs hypersensitivity reactions (DHRs) phenotyping and management.MethodsThis retrospective cohort included patients experiencing DHRs during chemotherapy. Under allergist supervision, SDD was performed once the index reaction was controlled. At a later date, clinical phenotypes and endotypes of DHRs were assessed through clinical history, skin tests, serum biomarkers (including tryptase and IL-6 levels), and drug provocation testing (DPT) to reach an accurate diagnosis.ResultsSDD was successful in 35 cases, even for patients with severe initial reactions. Only 14% experienced breakthrough reactions, all mild. Same-day assessment by allergists ensured a 92% correlation between initial and final diagnoses, optimizing DHR management. Early engagement with Allergy allowed 86% of reactive patients to continue treatment through RDD or after ruling out an allergy.ConclusionSDD is a safe and effective procedure that ensures that patients don't miss their oncology treatment on the day of a reaction. The presence of an allergist in the OIC is crucial for rapid access to accurate DHR phenotyping and optimal management, supporting personalized precision medicine in oncology. |
| format | Article |
| id | doaj-art-809b50aac03f46edbf2b76f6d5aab4ab |
| institution | Kabale University |
| issn | 2673-6101 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Allergy |
| spelling | doaj-art-809b50aac03f46edbf2b76f6d5aab4ab2024-12-11T06:44:35ZengFrontiers Media S.A.Frontiers in Allergy2673-61012024-12-01510.3389/falgy.2024.14794691479469The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion CenterJulián Borrás Cuartero0Maria Cruz Torres Górriz1Maria Cruz Torres Górriz2Maria Cruz Torres Górriz3Cristina Isabel Stein Coronado4Cristina Isabel Stein Coronado5Adrián Germán Sánchez6Adrián Germán Sánchez7Cristina Giovanna Pesántez Méndez8Cristina Giovanna Pesántez Méndez9Maria Dolores Latorre Ibáñez10Ernesto Enrique11Ernesto Enrique12Ernesto Enrique13Allergy Department, Castellon Provincial Hospital Consortium, Castellon de la Plana, SpainAllergy Department, Castellon University General Hospital, Castellon de la Plana, SpainDoctoral School, Jaume I University, Castellon de la Plana, SpainFISABIO Foundation Research Group, Valencia, SpainAllergy Department, Castellon University General Hospital, Castellon de la Plana, SpainFISABIO Foundation Research Group, Valencia, SpainAllergy Department, Castellon University General Hospital, Castellon de la Plana, SpainFISABIO Foundation Research Group, Valencia, SpainAllergy Department, Castellon University General Hospital, Castellon de la Plana, SpainFISABIO Foundation Research Group, Valencia, SpainRIA Laboratory Service - Radiopharmacy, Castellon Provincial Hospital Consortium, Castellon de la Plana, SpainAllergy Department, Castellon University General Hospital, Castellon de la Plana, SpainDoctoral School, Jaume I University, Castellon de la Plana, SpainFISABIO Foundation Research Group, Valencia, SpainBackgroundHypersensitivity reactions to chemotherapy disrupt treatment schedules and compromise patient outcomes. Rapid Drug Desensitization (RDD) enables patients to tolerate future treatments after an allergy workup. However, Same-Day Desensitization (SDD) is a novel approach that capitalizes on RDD to allow the continuation of chemotherapy on the same day as the index reaction, preventing treatment delays.ObjectiveTo evaluate the safety and efficacy of SDD in managing hypersensitivity reactions during chemotherapy and emphasize the essential role of allergists in the Oncology Infusion Center (OIC) for accurate drugs hypersensitivity reactions (DHRs) phenotyping and management.MethodsThis retrospective cohort included patients experiencing DHRs during chemotherapy. Under allergist supervision, SDD was performed once the index reaction was controlled. At a later date, clinical phenotypes and endotypes of DHRs were assessed through clinical history, skin tests, serum biomarkers (including tryptase and IL-6 levels), and drug provocation testing (DPT) to reach an accurate diagnosis.ResultsSDD was successful in 35 cases, even for patients with severe initial reactions. Only 14% experienced breakthrough reactions, all mild. Same-day assessment by allergists ensured a 92% correlation between initial and final diagnoses, optimizing DHR management. Early engagement with Allergy allowed 86% of reactive patients to continue treatment through RDD or after ruling out an allergy.ConclusionSDD is a safe and effective procedure that ensures that patients don't miss their oncology treatment on the day of a reaction. The presence of an allergist in the OIC is crucial for rapid access to accurate DHR phenotyping and optimal management, supporting personalized precision medicine in oncology.https://www.frontiersin.org/articles/10.3389/falgy.2024.1479469/fulldrug allergyRapid Drug DesensitizationSame-Day Desensitizationchemotherapy allergypersonalized and precision medicine |
| spellingShingle | Julián Borrás Cuartero Maria Cruz Torres Górriz Maria Cruz Torres Górriz Maria Cruz Torres Górriz Cristina Isabel Stein Coronado Cristina Isabel Stein Coronado Adrián Germán Sánchez Adrián Germán Sánchez Cristina Giovanna Pesántez Méndez Cristina Giovanna Pesántez Méndez Maria Dolores Latorre Ibáñez Ernesto Enrique Ernesto Enrique Ernesto Enrique The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion Center Frontiers in Allergy drug allergy Rapid Drug Desensitization Same-Day Desensitization chemotherapy allergy personalized and precision medicine |
| title | The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion Center |
| title_full | The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion Center |
| title_fullStr | The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion Center |
| title_full_unstemmed | The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion Center |
| title_short | The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion Center |
| title_sort | increasing role of the allergist in the management of infusion reactions at the oncology infusion center |
| topic | drug allergy Rapid Drug Desensitization Same-Day Desensitization chemotherapy allergy personalized and precision medicine |
| url | https://www.frontiersin.org/articles/10.3389/falgy.2024.1479469/full |
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