Description
Title: Evaluation of Rituximab-Related Clinical Hypersensitivity in Patients with B-Cell Neoplasia
Abstract: Although they are uncommon, rituximab hypersensitivity reactions are one of the main reasons that it is removed from antilymphoma immunochemotherapy regimens. Hypersensitivity reactions (HSR) do not go away with subsequent administrations but rather intensify, even though the clinical picture may be difficult to distinguish from other infusion-related reactions. Objective. To explain the application of the 12-step protocol for rituximab desensitization in clinical practice and the complementary investigation of a potential IgE-mediated HSR in the context of rituximab treatment for B-cell lymphoma. Methods. Ten patients with a history of severe infusion reactions or patients who experienced a repeat reaction despite taking more stringent preventive measures underwent a 12-step rituximab desensitization protocol prospectively in clinical practice. In order to eliminate false negatives brought on by potential drug interference, skin prick tests were carried out both immediately after the reaction and later. Results. In general, 70% of patients were able to complete the planned immunochemotherapy thanks to the desensitization protocol. Due to clinical persistence in two patients and lymphoma progression in the third, the therapy had to be stopped in both cases. Only 20% of intradermal tests with 0.1% rituximab were positive, indicating a hypersensitive mechanism. Conclusions. The 12-step protocol for desensitization is extremely effective and widely accepted in medical practice. Due to the possibility of future drug exposure, it is necessary to identify the mechanism underlying the infusion reaction in a significant number of cases.
Paper Quality: SCOPUS / Web of Science Level Research Paper
Subject: Medicine
Sub Category: Hematology
Writer Experience: 20+ Years
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