Specific Immunotherapy in Hymenoptera Venom Allergy and Concomitant Malignancy: A Retrospective Follow-up Focusing on Effectiveness and Safety
Aeberhard J1, Haeberli G1, Müller UR1, Helbling A1,2
1Allergy Unit Zieglerspital, Clinic of Internal Medicine, Spital Netz Bern AG, Bern, Switzerland
2Division of Allergology, University Clinic of Rheumatology, Immunology & Allergology, Inselspital/University Hospital Bern, Switzerland*
Note: Due to the decision of the cantonal government of Bern, the Zieglerspital was closed at the end of September 2015. The Allergy Unit was merged with the Division of Allergology, University Clinic of Rheumatology, Immunology & Allergology, Inselspital. The present study is the last publication of the Allergy Unit Zieglerspital.
J Investig Allergol Clin Immunol 2017; Vol 27(6)
Introduction: Malignancies are often considered a contraindication for allergen-specific immunotherapy. Consequently, patients with severe Hymenoptera venom allergy and cancer require specific care. The aim of this retrospective study was to assess patients with Hymenoptera venom allergy and cancer undergoing venom immunotherapy (VIT).
Methodology: The study population comprised all patients referred for evaluation of Hymenoptera venom allergy or for a routine check-up during VIT from January 1, 2004 to December 31, 2008.
Results: Of the patients assessed, 2% (51 of 2594) had a documented Hymenoptera venom allergy and cancer (25 female, 26 male; mean age 58 years). Of these, 42 patients received VIT (82%): 25 patients had a previously diagnosed malignancy, 16 were diagnosed with malignancy during VIT, and 1 patient was diagnosed with cancer after completion of VIT. The most frequent type of tumor was breast cancer in female patients (60%) and prostate cancer in male patients (39%). Systemic allergic reactions during VIT were recorded in 7% of patients. A total of 19 patients experienced a field sting or underwent a sting challenge test during VIT: 95% tolerated the sting well. VIT was halted definitively in 9 patients (new diagnosis of cancer in 7 patients, reactivation of cancer in 1, and progressive polyneuropathy in 1).
Conclusion: The effectiveness and adverse effects of VIT in patients with Hymenoptera venom allergy and cancer in remission are comparable to those of patients without malignancy. Our findings show that patients with Hymenoptera venom allergy and cancer are eligible for VIT.
Key words: Allergy, Cancer, Hymenoptera venom allergy, Malignancy, Venom immunotherapy