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

BACKGROUND: Brentuximab vedotin (BV) is an antibody–drug conjugate formed by an anti-CD30 chimeric IgG(1) 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.