Background and importance The use of a desensitisation protocol (DP) allows tolerance to drugs to which a hypersensitivity reaction has occurred, allowing treatment options which in some cases are the only ones available.
Aim and objectives Describe the use of a DP for ibrutinib in a patient with limited treatment options.
Material and methods 67-year-old woman with stage IV chronic lymphatic leukemia, not a candidate for transplantation, with a history of relapse to previous treatments. After 14 months of treatment with ibrutinib with good tolerance, a serious late reaction arose with a generalised purpuric rash of several days of evolution, and arthromyalgia that required hospitalisation and drug discontinuation, with subsequent clinical resolution.
Intradermal test for differential diagnosis of allergy versus late cutaneous adverse reaction was not conclusive for sensitisation to ibrutinib and a DP was proposed based on Phadke et al.1
Results Ibrutinib capsules were dispersed in purified water. A DP was performed with both hospital and home administration. Daily doses were administered 1 hour apart (table 1).
The patient returned to the usual treatment with good tolerance.
Conclusion and relevance The DP allowed continuation with ibrutinib, with safety and good tolerance, without loss of this therapeutic option.
References and/or acknowledgements 1. Phadke NA, et al. Immediate reaction to ibrutinib amenable to oral desensitization. J Oncol Pharm Pract 2021;27(7):1802–1805.
Conflict of interest No conflict of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.