Hypersensitivity Reactions

Recently more attention has been focused on hypersensitivity reactions of cancer treatments because of cross-reactivity between agents, and the desire to continue active

therapies against the cancer. Bleomycin and asparaginase have skin tests suggested to be administered prior to administration. However, a negative skin test does not preclude an allergic reaction. For documented immediate hypersensitivity reactions to a particular agent, further administration of the agent may be achieved through extensive premedication with H1 and H2 antihistamines and corticosteroids, and through use of escalating doses of the offending agent given at doses of one-hundredth, one-tenth, and the balance of the dose (so the total dose administered is equivalent to the normally prescribed dose) administered over a much longer period of time. These treatments must be given in an environment where resuscitation is readily available in case of medical emergency.

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