{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T13:10:26Z","timestamp":1779973826334,"version":"3.53.1"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: This study aimed to evaluate patients who developed hypersensitivity reactions (HSRs) during rituximab treatment and report the outcomes of desensitization protocols implemented to allow treatment continuation. Methods: We retrospectively reviewed the institutional data of 76 patients who received rituximab therapy at the Adult Hematology Department between January 2022 and September 2023. Among these, 11 patients who experienced immediate hypersensitivity reactions during infusion were analyzed. The overall frequency of rituximab-associated HSRs was 14.47% (11 out of 76 patients). Demographic data, underlying diseases, timing and type of HSRs, and details of the desensitization protocols were recorded. Results: The overall frequency of rituximab-associated HSRs was 14.47% (11 out of 76 patients). Among the 11 patients, eight were male and three were female, with a median age of 56 years (range: 19\u201372). Eight patients had CD20-positive non-Hodgkin lymphoma (NHL) and three had acute B-lymphoblastic leukemia (B-ALL). HSRs occurred during the first rituximab exposure in nine patients, at the fourth dose in one patient, and at the eighth dose in another. Symptoms included widespread rash, pruritus, flushing, chills, shivering, dyspnea, dysphagia, back pain, dizziness, syncope, and throat discomfort. All the patients were consulted by the Allergy and Immunology Clinic. Based on prick and intradermal test (IDT) results and the planned rituximab dose, desensitization protocols consisting of a three-dilution\/12-step and a four-dilution\/16-step regimen were prepared. Overall, 46 desensitization procedures were successfully completed in 11 patients. Notably, no severe anaphylactic events or treatment discontinuations due to drug toxicity occurred during the implementation of the protocols. Conclusions: Although the number of patients was limited, our findings indicate that in patients with hematologic malignancies receiving rituximab who develop early HSRs, desensitization represents a safe and effective strategy before considering treatment modification. These results support that, in appropriately selected patients, desensitization protocols are an important approach to continue therapy without interruption while minimizing adverse reactions.<\/jats:p>","DOI":"10.3390\/jcm15114164","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T12:09:07Z","timestamp":1779970147000},"page":"4164","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Rituximab-Associated Hypersensitivity Reactions with Successfully Applied Desensitization Protocols: A Clinical Experience of 46 Infusions in 11 Patients"],"prefix":"10.3390","volume":"15","author":[{"given":"\u00d6mer","family":"Candar","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"},{"name":"Department of Hematology, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vildan","family":"\u00d6zkocaman","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raziye","family":"T\u00fcl\u00fcmen \u00d6zt\u00fcrk","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Chest Diseases, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5419-3221","authenticated-orcid":false,"given":"Tuba","family":"Ersal","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6744-9676","authenticated-orcid":false,"given":"Esra","family":"G\u00fclderen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5129-2977","authenticated-orcid":false,"given":"Cumali","family":"Yal\u00e7\u0131n","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinem","family":"\u00c7ubuk\u00e7u","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuba","family":"G\u00fcll\u00fc Koca","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4991-9830","authenticated-orcid":false,"given":"Faz\u0131l \u00c7a\u011fr\u0131","family":"Hunutlu","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015eeyma","family":"Yavuz","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2954-4293","authenticated-orcid":false,"given":"Dane","family":"Ediger","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Department of Chest Diseases, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9710-134X","authenticated-orcid":false,"given":"Fahir","family":"\u00d6zkalemka\u015f","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1038\/nri2747","article-title":"Strategies and challenges for the next generation of therapeutic antibodies","volume":"10","author":"Beck","year":"2010","journal-title":"Nat. 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