Brigham and Women’s Drug Hypersensitivity and Desensitization Center

The Drug Hypersensitivity and Desensitization Center serves patients with drug allergy, providing them with the opportunity to receive the first line treatments that are essential to their medical care. Through careful evaluation, select testing, and desensitization, the team of providers in the Center has facilitated the care of thousands of patients.

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How We Can Help

Evaluation and diagnosis of Drug Hypersensitivity
Desensitization to antibiotics, chemotherapy, monoclonal antibodies, iron products, small molecules, progesterone, and other medications
Participation in clinical trials and ongoing desensitization research

Mariana C. Castells, MD, Director, Drug Hypersensitivity and Desensitization Center at Brigham and Women's Hospital, describes the process of drug desensitization, a method in which a drug can be safely re-introduced to a patient who has become allergic to their medication. Read the Drug Desensitization video transcript.

What Sets Us Apart

We have the largest center in the US that provides evaluation of drug hypersensitivity, risk stratification, and desensitization options including high-risk desensitization for chemotherapy and monoclonal antibodies. Our program has performed thousands of desensitizations since its inception in 1995, with almost 900 desensitizations now performed on a yearly basis.
With careful risk stratification, we are able to offer desensitizations across a range of settings including outpatient clinics at the Building of Transformative Medicine and at the Dana-Farber Cancer Research Center, and inpatient units at BWH and BWH Faulkner Hospitals.
Our 3 bag, 12 step protocol has been used nationally and internationally and has received national and international recognition for providing improved patient survival.
We offer participation in ongoing clinical studies on the genetics of drug allergy, nanoparticles for allergy diagnosis, and therapeutic trials.
Our center has supported numerous clinical studies that have led to discoveries and publications.
National and international physicians, pharmacists, fellows, and nurses also rotate through the Center.

A Protocol of Hope

Stage	Description
Drug Reaction	An allergic reaction occurs after a patient is exposed to a medication
Diagnostic Testing and Risk Stratification	A skin test and clinical evaluation shed insight into if a reaction was immunoglubluin-E (IgE) mediated or non-IgE mediated. IgE is the type of antibody that maps specificity to an allergy. For example, if a patient reacts to their first-line chemotherapy or other medication they probably have an IgE-specific allergy to the drug circulating in the blood
Protocol	The prescribed dose of the medication is placed into an algorithm to create a 1 bag / 4 step, 2 bag / 8 step or 3 bag / 12 step infusion protocol. Decisions on protocols are made by an allergist and are based on the mechanism of the reaction, skin testing and patient symptoms
Treatment	The treatment introduces small increasing doses of drug to the patient in 15-minute intervals until the patient is considered desensitized and the final dose is safely reached. This occurs on one day over several hours.
Tolerance	The desensitized state is temporary and only lasts for a short window of time. Once a patient enters the desensitization program, all subsequent infusions of the allergic drug will be given as desensitizations for as long as needed or until an allergist deems it safe to receive the allergic drug in normal infusion

Our Experts

Director

Mariana Castells MD, PhD

Associate Director

David Sloane, MD

Attending Physicians

Desensitization Nurse Practitioner

Donna-Maria Lynch, FNP-BC

Desensitization Pharmacist

Kathleen Marquis Pharm D, PhD

Desensitization Coordinator

Kylie Besz, MS, MPH

Schedule an Appointment

For providers : Please contact Kylie Besz, Desensitization Coordinator, at 617-5251222, if interested in having your patient evaluated for possible desensitization.

For patients : Please contact your doctor to evaluate the possibility of desensitization. They will need to contact the coordinator directly

Refer a Patient

All patients must be referred by a physician. Referral Forms must be filled out by a referring physician.

Highlighted References

Location

Brigham and Women’s Hospital
60 Fenwood Road
Hale Building for Transformative Medicine
Boston, MA 02115
Phone: (617) 732-9850