Original Paper

Malignancy and Specific Allergen Immunotherapy: The Results of a Case Series
Stefan Wöhrl, Tamar Kinaciyan, Ahmad Jalili, Georg Stingl, Katharina B. Moritz

Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna, Vienna, Austria

Address of Corresponding Author

Int Arch Allergy Immunol 2011;156:313-319 (DOI: 10.1159/000323519)

  Key Words

• Allergy
• Allergen vaccination
• Cancer
• Contraindication
• Desensitization
• Hymenoptera allergy
• Melanoma
• Rhinoconjunctivitis
• Tumor
• Yellow jacket

  Abstract

Background: Specific immunotherapy with allergen is the only causative treatment for IgE-mediated allergies such as stinging insect allergy or hay fever and works by the induction of blocking antibodies and regulatory T lymphocytes. Objective: Does a hypothetical obstruction of tumor surveillance presupposing the induction of regulatory T cells really justify detaining immunotherapy to oncologic patients as suggested by recent guidelines? Methods: We report 6 patients (4 female, 2 male) suffering or having suffered from stage 1 cancer (4 melanomas, 1 lung cancer, 1 breast cancer) and concomitant IgE-mediated allergy. Four of them had a history of severe anaphylactic reactions to the insect yellow jacket, the 5th suffered from allergic rhinoconjunctivitis to dust mites, and the 6th to grass/rye pollen. Results: Between 2004 and 2010, subcutaneous immunotherapy was safely performed in 5 patients without signs of tumor reactivation. The cancer in 2 of them was diagnosed immediately after specific immunotherapy had been initiated and in another 2 the active cancer phase had already finished years before; the 5th suffered from a relapse around the time of the initiation of immunotherapy. At the time of the writing of the manuscript, 4 of them had already concluded 3 years of treatment, another one almost 1 year. The melanoma in the 6th patient was diagnosed 5 months after reaching the maintenance dose. Immunotherapy with grass/rye pollen was aborted in this patient based on current guidelines. Conclusions: Specific immunotherapy was safely administered in patients suffering concomitantly from IgE-mediated allergy and lower stage cancer.

Copyright © 2011 S. Karger AG, Basel

  Author Contacts

Correspondence to: Dr. Stefan Wöhrl
Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna
Währinger Gürtel 18–20, AT–1090 Vienna (Austria)
Tel. +43 140 400 7704, E-Mail stefan.woehrl@meduniwien.ac.at

  Article Information

Received: October 4, 2010
Accepted after revision: December 6, 2010
Published online: June 29, 2011
Number of Print Pages : 7
Number of Figures : 0, Number of Tables : 3, Number of References : 26