去标记途径提供了确诊，并且可以防止化疗超敏反应（CHT-HSR）后不必要的二线治疗或药物脱敏程序。然而，这些途径依赖于有风险的体内测试。关于体外测试是否有用的数据很少。我们评估了嗜碱性粒细胞激活试验 (BAT) 在诊断铂盐 (PS) 和紫杉​​烷 (TX) HSR 中的作用，该人群具有不同的内表型和 HSR 严重程度。我们进行了一项为期 3 年的多中心研究，对 121 名疑似即刻 CHT-HSR 患者进行的前瞻性研究。过敏检查包括临床病史（基于 I 型、细胞因子释放综合征和混合表型症状的初始反应，如果无法符合其中任何一个，则为“不确定”）、皮肤测试 (ST) 和药物激发试验 (DPT) ），前提是风险评估是有利的。最终诊断将患者分为“过敏”、“非过敏”或“不确定”。我们使用 CD63 和 CD203c 作为患者和对照的激活标记物进行 BAT。无论 BAT 结果如何，患者都接受 DPT，以防止偏差。ST 阳性与皮肤受累、I 型表型、癌症复发和反应前终生暴露显着相关。所有不确定表型患者 (p = .02) 和低风险患者的 DPT 均为阴性，而 62% 中危患者的 DPT 为阴性。 55% 被确认为过敏（主要是 I 型反应，p< .0001），24% 被确认为非过敏（主要是 TX 和不确定表型），21% 为不确定。 BAT 在 I 型 IgE 介导的 PS 反应中表现出 79% 的敏感性，与 ST 高度相关。BAT 是一种有前景的 CHT-HSR 去标记和内型分析工具，尤其是对 PS 的 I 型反应，可能识别有 DPT 阳性风险的患者。 ST 似乎有助于确认 CHT-HSR，尤其是 PS 引起的反应，而 DPT 仍然是黄金标准，即使对于中危患者也至关重要。© 2024 作者。欧洲过敏与临床免疫学研究院和约翰·威利出版的《过敏》

Delabelling pathways offer confirmatory diagnosis and can prevent unnecessary second-line therapies or drug desensitization procedures after chemotherapeutic hypersensitivity reactions (CHT-HSRs). However, these pathways rely on risky in vivo tests. Data on whether in vitro tests could be helpful are scarce. We assessed the role of basophil activation test (BAT) in the diagnosis of HSRs to platin salts (PSs) and taxanes (TXs) in a well-defined population featuring varied endophenotypes and severities of HSRs.We conducted a 3-year-long multicentric, prospective study with 121 suspected-immediate CHT-HSR patients. The allergy workup included clinical history (initial reaction based on Type I, cytokine release syndrome, and mixed phenotype's symptoms and if unable to fit in any of these, as "indeterminate"), skin testing (ST), and drug provocation testing (DPT), provided risk assessment was favorable. Final diagnosis classified patients as "hypersensitive," "non-hypersensitive," or "inconclusive." We performed BAT using CD63 and CD203c as activation markers in patients and controls. Patients underwent DPT regardless of BAT results to prevent bias.ST positivity significantly correlated with skin involvement, Type I phenotype, cancer recurrence, and lifetime exposures before reactions. DPTs were negative in all indeterminate phenotype patients (p = .02) and those considered low-risk, whereas they were negative in 62% moderate-risk patients. 55% were confirmed as hypersensitive (mainly Type I reactions, p < .0001), 24% as non-hypersensitive (mainly TXs and indeterminate phenotypes), and 21% as inconclusive. BAT showed 79% sensitivity in Type I IgE-mediated reactions to PSs with a high correlation to ST.BAT is a promising tool for delabelling and endotyping CHT-HSRs, especially Type I reactions to PSs, possibly identifying patients at risk of positive DPT. ST seems useful in confirming CHT-HSRs, especially PS-induced reactions, and DPT remains the gold standard, being essential even in moderate-risk patients.© 2024 The Author(s). Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.