Reply to: Successful Isatuximab Desensitization in a Patient With Refractory Multiple Myeloma and Indolent Systemic Mastocytosis

• Published in: Journal of investigational allergology & clinical immunology Vol. 34; no. 3; p. 216
• Main Authors: Torres Górriz, M C, Borrás Cuartero, J, Pesántez Méndez, C G, Stein Coronado, C I, Enrique, E
• Format: Journal Article
• Language: English
• Published: Spain Esmon Publicidad 17-06-2024
• Subjects: Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Case reports; Cell activation; Desensitization, Immunologic - methods; Humans; Hypersensitivity; Leukocytes (basophilic); Mastocytosis; Mastocytosis, Systemic - diagnosis; Mastocytosis, Systemic - drug therapy; Mastocytosis, Systemic - immunology; Multiple myeloma; Multiple Myeloma - drug therapy; Multiple Myeloma - immunology; Skin tests; Isatuximab; Desensitization; Monoclonal antibody; Anaphylactic shock; Hypersensitivity reaction
• ISSN: 1018-9068; 1698-0808
• DOI: 10.18176/jiaci.0992

Torres Gorriz et al respond to a case report published in the journal regarding successful desensitization of a patient with refractory multiple myeloma and indolent systemic mastocytosis who experienced a hypersensitivity reaction to the drug isatuximab. The authors describe their own practice of rapid drug desensitization (RDD) using a 4-bag protocol for patients with severe symptoms of hypersensitivity reaction (HR) and positive skin tests. They gradually reduce the number of vials until RDD can be performed with just one bag. The authors report that the patient in their case has undergone multiple RDDs without any breakthrough reactions, allowing them to continue their therapeutic regimen. They also discuss the challenges of interpreting skin test results for isatuximab and suggest that the basophil activation test may be useful in cases where skin tests cannot be interpreted. The authors conclude by emphasizing the importance of RDD in managing severe HR with rare drugs and concomitant mast cell activation syndrome. They express gratitude to the authors of the original case report and declare no conflicts of interest.