Monoclonal antibodies, immunogenicity, and associated infusion reactions.

The increasing use of monoclonal antibodies as treatment modalities for a number of immune mediated and malignant diseases has yielded great promise. In using this approach, however, we have encountered problems, in terms of infusion reactions. Two forms of reactions have been identified: acute and delayed; they appear to be related to the presence of antibodies to the monoclonal antibodies (against murine or human components). The reactions are largely not anaphylactic (IgE mediated), making it possible to re-treat patients using specific protocols. These protocols are detailed in this overview.