Biomarkers Associated with Hypersensitivity Reactions to Chemotherapeutic Agents.

Abstract

New phenotypes of hypersensitivity reactions (HSR) have been described due to the wide use of chemotherapy, however, biomarkers other than tryptase to confirm the reaction are not feasible. Our goal was to determine the value of tryptase and IL-6 during desensitization to chemotherapy agents. The phenotype of the HSR was established according to the clinical characteristics, the result of the skin tests and the biomarkers (tryptase and IL-6) at the time of the initial reaction during desensitization. Tryptase were quantified by ImmunoCAP and IL-6 was quantified by flow cytometry using the CBA method. We compare the results of 8 patients, 4 of them presented HSR suggestive of phenotype 1 (Ph1); the other 4 patients had cytokine release reactions (CRR) over 55 desensitization procedures. The mean baseline tryptase level in Ph1 was 5.25±0.99 ng/ml vs 5.05±1.67 in CRR; while during the desensitization reactions were 9.2±4.79 vs 3.37±0.9 respectively (p<0.05). On the other hand, the mean baseline IL-6 levels was 10 pg/ml in both groups, but after reactions during desensitization in the CRR the levels were 6659pg/ml±9026.2 pg/ml, but no change was observed in patients with Ph1 (p<0.01). Tryptase increases were detected in patients with Ph1, while IL-6 elevations were observed in CRR. We didn’t have blended reactions until now. Tryptase elevation occurred in patients with IgE-mediated reactions, without changes in the IL-6 levels. But the opposite is true in CRR that raises IL-6 but no tryptase levels, thus IL-6 could be a potential biomarker for identifying cytokine-release reactions.