Clinical Experience with a One-Bag Rapid Drug Desensitization Protocol in Patients with Chemotherapy-Induced Hypersensitivity Reactions

Şeyma Özden; Fatma Merve Tepetam

doi:10.5281/zenodo.19238252

Authors

Şeyma Özden University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital https://orcid.org/0000-0002-6646-9894
Fatma Merve Tepetam Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital https://orcid.org/0000-0002-9794-5662

DOI:

https://doi.org/10.5281/zenodo.19238252

Keywords:

Hypersensitivity Reactions, Desensitization, Type I Hypersensitivity

Abstract

Objective: Hypersensitivity reactions (HSRs) to chemotherapeutic agents represent a major clinical challenge, as they may prevent patients from receiving first-line and indispensable oncologic treatments. The aim of this study was to evaluate the clinical experience with a one-bag rapid drug desensitization (RDD) protocol in patients with chemotherapy-induced HSRs, focusing on safety and feasibility.

Materials and Methods: This single-center, retrospective, observational cohort study included patients who underwent one-bag RDD for chemotherapy-induced HSRs between December 2020 and December 2023. Demographic characteristics, culprit drugs, type and severity of HSRs, occurrence of breakthrough reactions (BTRs), and desensitization outcomes were analyzed.

Results: A total of 87 one-bag RDD procedures were performed in 21 patients. The majority of patients were female (71.4%), with a mean age of 55.8±8.5 years. Most index reactions were classified as type I HSRs (90.5%), and 33.3% of patients had a history of severe (grade 3) reactions prior to desensitization. Desensitization was successfully completed without BTRs in 90.5% of patients. Mild BTRs (grade 1) occurred in two patients and were managed without interruption of chemotherapy.

Conclusion: The one-bag rapid drug desensitization protocol is a safe, effective, and feasible approach for managing chemotherapy-induced hypersensitivity reactions and represents a practical alternative for maintaining essential oncologic treatments in real-life clinical settings.

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