XXXX to therapeutic murine monoclonal antibodies.

@entity1 @entity96 @entity5 @entity19 @entity1820 @entity56 @entity3
OBJECTIVE: To determine the predictive value of pre-treatment skin tests and in vitro IgE/IgG4 anti-murine monoclonal antibodies in @entity1 treated with murine monoclonal antibodies. DESIGN: @entity1 treated at two @entity5 institutions were evaluated by skin testing and solid phase immunoassays to detect IgE and IgG4 specific anti-murine monoclonal antibodies. Skin testing by scratch and intradermal skin testing was done on @entity1 before treatment with murine monoclonal antibodies. IgE _ IgG4 specific anti-murine monoclonal antibodies were determined before treatment in all @entity1 and at 1, 7, 14 and 21 days post-treatment in 1 @entity1 . SETTING: @entity5 @entity1 undergoing murine monoclonal antibody treatment in two university medical centers were recruited for the study. @entity1 : Twelve @entity1 , aged 41-75 years with @entity1820 ( @entity96 ) with @entity3 , who had relapses or conventional therapy were enrolled. Some @entity1 had previous exposure to rodents, either as laboratory personnel or had kept them as pets. INTERVENTION: One @entity1 who experienced an anaphylactic reaction to murine monoclonal antibody infusion was desensitized so therapy could continue. MAIN OUTCOME MEASURES: Skin tests, immunoassays, and @entity1 history were correlated with adverse reactions to infusions of murine monoclonal antibodies. MAIN RESULTS: Skin tests (scratch method) and/or in vitro immunoassays may predict @entity56 outcomes in @entity1 receiving infusions of murine monoclonal antibodies. Intradermal skin testing with murine monoclonal antibodies may result in false positive reactions and have less predictive value. Specific IgE or IgG4 were elevated in the two @entity1 who experienced severe adverse reactions to murine monoclonal antibodies but not in those @entity1 with no reactions and therefore, may have some predictive value. A history of past exposure to @entity19 may also increase the risk of adverse reactions. In one @entity1 , intravenous desensitization enabled treatment to proceed. CONCLUSION: Scratch skin tests, in vitro IgE and/or IgG4 immunoassays together with a past history of previous exposure to murine antigen(s) may predict @entity56 to therapy with murine monoclonal antibodies.
