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      Multiple successful desensitizations to brentuximab vedotin: a case report and literature review.

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          Abstract

          Brentuximab vedotin is an antibody-drug conjugate FDA-approved for the treatment of systemic anaplastic large-cell lymphoma (ALCL) that has relapsed after multiagent chemotherapy. At least 2 cases of hypersensitivity reactions to brentuximab vedotin have been reported, without attempted desensitization. This report describes a morbidly obese 32-year-old woman with ALCL that relapsed after autologous stem cell transplantation, who was treated on a phase II clinical study with brentuximab vedotin. After 1 dose, she experienced near-complete remission, but therapy was stopped because of severe drug-related toxicity. She then received 5 cytotoxic treatments and radiation, and ultimately experienced disease progression. The patient was rechallenged with brentuximab vedotin approximately 28 months after initial exposure and tolerated the dose well, but experienced a significant allergic reaction with the next dose. High-dose steroid and antihistamine prophylaxis administered 50 minutes before the subsequent brentuximab vedotin infusion was unsuccessful in mitigating this reaction. Brentuximab vedotin was successfully infused according to a rapid desensitization protocol. With progressive dose titration and supportive care, the patient tolerated this therapy. She received 11 doses through a rapid desensitization protocol and experienced a durable disease remission.

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          Author and article information

          Journal
          J Natl Compr Canc Netw
          Journal of the National Comprehensive Cancer Network : JNCCN
          1540-1413
          1540-1405
          Apr 2014
          : 12
          : 4
          Affiliations
          [1 ] From the aDepartment of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; bDivision of Hematology/Oncology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts; and cDivision of Hematology/Oncology, Northwestern University Feinberg School of Medicine, dRobert H. Lurie Comprehensive Cancer Center of Northwestern University, and eDivision of Allergy/Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
          Article
          12/4/465
          24717566
          a6e167c3-df7f-4074-af0e-ed3a85d240b7
          History

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