Multiple Successful Desensitizations to Brentuximab Vedotin: A Case Report and Literature Review

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.

Target Audience

This activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Describe the rationale for the use of brentuximab vedotin in the treatment of patients with relapsed sALCL
  • Review the options for desensitization in patients with relapsed or refractory sALCL and hypersensitivity to brentuximab vedotin
Additional information
Supporters: 

No commercial support was received for this article.

Course summary
Available credit: 
  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician
Course opens: 
04/11/2014
Course expires: 
04/11/2015
Cost:
$0.00

Michael D. DeVita, MD
Department of Medicine
Northwestern University Feinberg School of Medicine
Chicago, Illinois

Andrew M. Evens, DO, MSc
Division of Hematology/Oncology
The University of Massachusetts Medical School
Worcester, Massachusetts

Steven T. Rosen, MD
Division of Hematology/Oncology
Northwestern University Feinberg School of Medicine
Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Chicago, Illinois

Paul A. Greenberger, MD
Division of Allergy/Immunology
Northwestern University Feinberg School of Medicine
Chicago, Illinois

Adam M. Petrich, MD
Division of Hematology/Oncology
Northwestern University Feinberg School of Medicine
Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Chicago, Illinois

Available Credit

  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician

Accreditation Period

Course opens: 
04/11/2014
Course expires: 
04/11/2015

Price

Cost:
$0.00
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  • Adobe Reader or other PDF reader software for article and certificate viewing/printing