Background Brentuximab is a monoclonal antibody targeting CD30 receptors, authorised in 2011 by FDA for the treatment of Hodgkin’s lymphoma and other lymphomas refractory to conventional treatment.
Although there are limited references in the literature to related infusion reactions, they are an adverse effect described in the data sheet and can compromise treatment.
Purpose To describe a case of hypersensitivity reaction to brentuximab and evaluate the utility of a desensitisation protocol.
Materials and methods Male, 29 years old, diagnosed with Hodgkin’s lymphoma in progression to different lines of chemotherapy.
Brentuximab was prescribed every 21 days at a dose of 180 mg over 30 min and premedicated with intravenous methylprednisolone, dexchlorpheniramine and paracetamol.
During the first cycle he didn’t present any reaction.
Twenty minutes after starting the second cycle, the patient presented a feeling of numbness in the extremities, itchy skin lesions, heat and nausea, so the infusion was stopped. He was treated with intravenous paracetamol and dexchlorpheniramine. The infusion was restarted but the signs reappeared, so was stopped. The severity of the reaction was considered grade 2.
During the third cycle skin lesions reappeared and although the cycle was completed, it was suspended.
The need to continue with the treatment led to a desensitisation protocol for brentuximab being prescribed, which consisted of 13 steps with a final dose equal to the therapeutic dose over 3 h and 10 min. At each step the dose was gradually increased until the full dose was reached. The initial dose was 0.01 mg and generally at each step twice the previous dose was given. The protocol was administered by the Allergy Service.
Results Since brentuximab protocol desensitisation was prescribed, the patient has received 3 cycles, during which he hasn’t experienced any reaction, allowing continued treatment.
Conclusions The use of a brentuximab desensitisation protocol allows patients with allergic reactions to the drug to be treated when it is the only available option.
No conflict of interest.
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