Ayşegül DUMLUDAĞ, İrfan BUĞDAY, Funda YILMAZ
Anatolian Current Medical Journal - 2026;8(1):111-115
Aims: Chemotherapy-related hypersensitivity reactions (HSRs) range from mild symptoms to life-threatening anaphylaxis. Accurate differentiation is essential for treatment decisions. This study aimed to evaluate the diagnostic value of combining serum tryptase levels with a standardized clinical severity score in patients who developed chemotherapy-induced HSRs. Methods: This retrospective, single-center study included adult cancer patients who developed HSRs during chemotherapy and underwent serum tryptase testing within 1-4 hours of symptom onset. Anaphylaxis severity was classified using Brown's scoring system. The relationship between tryptase levels, clinical severity, and subsequent treatment modifications was analyzed, and diagnostic performance for predicting severe anaphylaxis was assessed using ROC analysis. Results: Ninety-seven patients were included. Elevated tryptase levels (>=11.4 ng/ml) were detected in 38% of patients and were strongly associated with severe anaphylaxis scores (>=5) (p<0.001). Among patients with elevated tryptase, 78% required treatment modification or desensitization, compared with 19% of those with normal levels. Serum tryptase demonstrated excellent predictive accuracy for severe anaphylaxis (AUC: 0.91). A small subgroup exhibited severe clinical features despite normal tryptase values, highlighting the need for combined clinical and biochemical assessment. Conclusion: Integrating serum tryptase measurement with standardized anaphylaxis scoring provides a reliable and practical approach to distinguishing true anaphylaxis from non-specific HSRs. This combined assessment improves diagnostic precision, supports timely therapeutic decisions, and may reduce unnecessary treatment modifications in oncology practice.
