Related Experiment Videos
Rapid desensitization for hypersensitivity reactions to chemotherapy agents
1Harvard Medical School, USA. Mariana_castells@hms.harvard.edu
Current Opinion in Allergy and Clinical Immunology
|July 11, 2006
Summary
Rapid desensitization protocols enable cancer patients with hypersensitivity reactions (HSRs) to chemotherapy to receive vital treatments. These protocols are safe, effective, and allow continued participation in clinical trials.
Area of Science:
- Oncology
- Allergy and Immunology
- Pharmacology
Background:
- Hypersensitivity reactions (HSRs) to chemotherapy agents pose significant challenges, limiting treatment options and potentially leading to severe outcomes.
- Alternative chemotherapy regimens may be less effective or unsuitable for first-line therapy.
- Rapid desensitization offers a method for patients to receive necessary chemotherapy despite prior HSRs.
Purpose of the Study:
- To review the indications for chemotherapy rapid desensitization.
- To highlight recent advancements in chemotherapy rapid desensitization protocols.
Main Methods:
- Review of existing intravenous and oral rapid desensitization protocols.
- Analysis of patient populations and reaction types (e.g., type I hypersensitivity, anaphylactoid reactions).
Main Results:
- Protocols exist for various agents including taxanes, platinums, doxorubicin, and monoclonal antibodies.
- Rapid desensitization is effective for both type I hypersensitivity and anaphylactoid reactions.
- Outpatient repeat desensitizations are well-tolerated, with no reported deaths and comparable cancer remission rates to non-desensitized patients.
Conclusions:
- Rapid desensitization protocols are a tolerable and effective option for selected cancer patients with chemotherapy HSRs.
- Improved education for healthcare professionals is crucial for the widespread adoption of these protocols as standard care.
Related Concept Videos
01:30Drug Toxicity: Allergic Reactions
Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial exposure to a...
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates these...
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
01:20Desensitization and Tachyphylaxis
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
Several...
Several...
01:30Allergic Reactions: Anaphylaxis
Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin, heparin),...
01:29Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists
Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Phenothiazines, such as prochlorperazine...