Rapid desensitization for brentuximab vedotin (Adceteris®) allergy: a case report

• Main Authors: Attilio Di Girolamo, Marcello Albanesi, Alessandro Sinisi, Eustachio Nettis, Danilo Di Bona, Maria Filomena Caiaffa, Luigi Macchia
• Format: Article
• Language: English
• Published: BMC 2018-10-01
• Series: Clinical and Molecular Allergy
• Subjects: Anti CD30; Auristatin-E; Hodgkin lymphoma; Desensitization; Monoclonal antibodies; Drug allergy
• Online Access: http://link.springer.com/article/10.1186/s12948-018-0100-0

Abstract Background Brentuximab vedotin (BV) is an antibody–drug conjugate formed by an anti-CD30 chimeric IgG1 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.