Otero Longo Itziar, Aranbarri Larrañaga Ane, Caminos Altuna Nerea, Martinez Molina Sara, Joral Badas Alejandro, Ondarra Segurola Laida, Lombardi Iglesias Clara, Diez Angulo Rosa Ana, Olabarria Santurtun Iciar, Araiz Ramirez Maria, Ceberio Echechipia Izaskun
Hospital Universitario Donostia, Hospital Universitario Donostia, Hospital Universitario Donostia, Hospital Universitario Donostia, Hospital Universitario Donostia, Hospital Universitario Donostia, Hospital Universitario Donostia, Hospital Universitario Araba, Hospital Universitario Basurto, Hospital Universitario Donostia, Hospital Universitario Donostia
Introduction: Brentuximab vedotin (BV) is an anti CD-30 antibody-drug conjugate to the antitubulin cytotoxic agent monomethyl aurastatin E. It is currently approved in Europe for refractory/relapsed Hodgkin's lymphoma (HL) after autologous stem cell transplantation (ASCT) or after at least 2 previous chemotherapy lines and for refractory/relapsed systemic anaplastic large-cell lymphoma (ALCL). Since its approval by the FDA in 2011, only 5 cases have been reported of patients who have had a desensitization protocol (DP) applied after having had an anaphylactic reaction (AR) to the drug.
Methods: In this work, we report 3 cases of patients from the Basque Autonomous Community who presented an AR to the BV:
*Table 1 After consultation with the Allergology service, a DP based on the Castells et al protocol was proposed. The BV was administered in a slow desensitization strategy using 3 solutions of 250cc of glucose solution infused in 12 steps. Example about a theoretical BV dose of 73 mg:
*Table 2 Pre-medication included: 5 mg of Dexchlorpheniramine, 50 mg of Ranitidine and 40 mg of Methylprednisolone 20 minutes before, all administered intravenously. At home patients took oral prophylaxis 2 days before treatment with 300 mg/day of acetylsalicylic acid and 10 mg/day of Montelukast.
Results: The patients after the PD received the subsequent cycles of BV without presenting any type of anaphylactic symptoms.
Conclusions: It is important to have protocols of desensitization to drugs such as BV, since these protocols allow the continuation of treatment in patients who have already received other lines of failed treatment and whose therapeutic options are limited.
Copyright © 2018 The Authors. Published by Wolters Kluwer Health Inc., on behalf of the European Hematology Association.