Rapid desensitization for brentuximab vedotin (Adceteris) allergy: a case report.
Attilio Di Girolamo, Marcello Albanesi, Alessandro Sinisi, Eustachio Nettis, Danilo Di Bona, Maria Filomena Caiaffa, Luigi Macchia
Author Information
Attilio Di Girolamo: 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy.
Marcello Albanesi: 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy. ORCID
Alessandro Sinisi: 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy.
Eustachio Nettis: 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy.
Danilo Di Bona: 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy.
Maria Filomena Caiaffa: 2Department of Medical and Surgical Sciences, School and Chair of Allergology and Clinical Immunology, University of Foggia, Via Luigi Pinto 1, 70100 Foggia, Italy.
Luigi Macchia: 1Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari-Aldo Moro, Piazza Giulio Cesare, Policlinico, 70124 Bari, Italy.
BACKGROUND: Brentuximab vedotin (BV) is an antibody-drug conjugate formed by an anti-CD30 chimeric IgG conjugated with monomethyl-auristatin-E. BV targets the CD30 cells, which characterize Hodgkin lymphoma as well as anaplastic large cell lymphoma. Once bound to the CD30 cells BV exerts its cytotoxic effect via the monomethyl-auristatin-E moiety. So far, accounts on immediate adverse reactions to BV remain anecdotal. Moreover, few reports exist on desensitization for BV. CASE PRESENTATION: A 20-year old male patient was diagnosed with Hodgkin lymphoma in July 2014. The first line treatment with adriblastine, bleomicine, vinblastine and dacarbazine lead to a partial remission. Thus, a treatment with BV was started. However, during the second BV infusion, he developed generalized urticaria and dyspnea. In order not to discontinue the treatment with BV, we performed a thorough allergological workup and designed a 12-step rapid desensitization protocol. Overall the desensitization procedure was well tolerated and no major adverse reactions occurred. CONCLUSION: Rapid desensitization is a suitable and safe option in the case of BV allergy and prevents the BV treatment withdrawal.
