Chemotherapeutic drugs have been widely used in the treatment of cancer
disease for about 70 years and, even with the development of new
therapies, they are still prescribed by oncologists, alone or in
combination with other antineoplastic agents. All chemotherapies are
able to provoke hypersensitivity reactions, even with different
incidences, depending on the different class of these drugs, and these
reactions are the third leading cause of fatal drug-induced anaphylaxis
in the United States. In Europe deaths related to chemotherapy have also
been reported. In particular, most reactions are provoked by platinum
compounds, taxanes, epipodophyllotoxins and asparaginase. However,
currently there are different points of view about the best procedures
for the diagnosis, treatment and prevention of these reactions. Thus,
the European Network on Drug Allergy and Drug Allergy Interest Group of
the European Academy of Allergy and Clinical Immunology organized a task
force to provide data and recommendations regarding the allergological
work up in this field of drug hypersensitivity reactions. The aims of
this position paper were to provide consensus on the investigation of
HSRs to chemotherapeutic drugs and to give practical suggestions for
clinicians that treat these patients, such as oncologists,
allergologists and internists. Key sections cover: risk factors,
pathogenesis, symptoms, role of skin tests, in vitro tests, indications
and contraindications of drug provocation tests and desensitization of
neoplastic patients with allergic reactions to chemotherapeutic drugs.
Statements, recommendations and unmet needs were discussed and proposed
at the end of each section.
Desensitization in delayed drug hypersensitivity reactions - an EAACI position paper of the Drug Allergy Interest Group