Temporary fix helps patients around drug allergy

Associated Press | 4/13/2010, 10:08 p.m.

The culprit isn’t always obvious. Montefiore’s Jerschow is testing a man whose open-heart surgery was aborted after he had a reaction to either the anesthesia - three drugs were used - or a precautionary antibiotic. His surgery can’t be rescheduled until she finds the cause.

When patients don’t have a good alternative, customized desensitization can calm the immune cells - called mast cells - that control this allergic response. Small amounts of the drug can bind to the cells in a way that prevents them from overreacting to the bigger dose.

The team - an allergist and specially trained nurses -- must know how to respond in case the desensitization is enough to spark a life-threatening reaction. In 2008, Castells published a series of 413 desensitizations to cancer drugs in 98 patients undergoing repeated treatments with medicines including carboplatin, Taxol and the monoclonal antibody Rituxan - and found 94 percent had a mild or no reaction.

There’s no count of how many hospitals have formal desensitization programs. Castells’ program desensitizes three to five people a day, including many patients who travel to Boston because their own doctors are unfamiliar with desensitization.

It can be scary for patients, too, says Mass General gynecologic oncology nurse Elizabeth Johnson.

“Anxiety itself can be a sign of a reaction so it gets tricky,” she says. But, “I’m betting this is going to become a larger and larger treatment phenomenon because other disciplines are catching on.”

EDITOR’S NOTE: Lauran Neergaard covers health and medical issues for The Associated Press in Washington.