Abstract

As the number of monoclonal antibodies in clinical use increases, our understanding of hypersensitivity and other adverse reactions to these agents becomes more intricate. The use of a classification scheme of these reactions can help elucidate possible underlying mechanisms and offer insights into management of reactions, including consideration of future administrations. Book chapters and journal articles relevant to monoclonal antibody production, adverse reactions, and desensitization were reviewed without restrictions on publication date. Selected case reports and meeting abstracts were included if no other evidence was available. We examine in this chapter the manifestations and possible mechanisms of adverse reactions to monoclonal antibodies, with emphasis on hypersensitivity and infusion reactions. Rituximab, omalizumab, and cetuximab provide specific illustrations of the complexities and heterogeneity of monoclonal antibody reactions. We consider the role of skin testing and rapid desensitization in diagnosis and treatment of monoclonal antibody hypersensitivity reactions.

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