Background Ifosfamide is an alkylating agent used in the treatment of a wide range of tumours. Because of known side effects it is usually administered in combination with mesna, a thiol agent with uroprotective activity, to reduce them and increase the therapeutic dose. The most frequently administered regimens for ifosfamide are fractionated doses for 3 to 5 days, high-dose intravenous bolus, and continuous infusion over 24 to 72 h. Hypersensitivity reactions to ifosfamide plus mesna are not frequently described in the literature. Moreover, no reports exist concerning desensitization for this chemotherapy combination. Case presentation A 47-year-old man with stage IV renal sarcoma was treated with the combination of ifosfamide and mesna every 3 weeks in a 4-consecutive-day infusion protocol. During the second cycle of chemotherapy, he presented acute cutaneous symptoms. A 12-step desensitization protocol was proposed in view of the lack of knowledge of the possible hypersensitivity reactions to this combination of chemotherapy agents, and the multiple difficulties found during the study of the case. Conclusions The 12-step desensitization protocol was well tolerated. Therefore, it is an appropriate and safe option in the case of suspected allergy to ifosfamide plus mesna.

Hypersensitivity reactions to chemotherapy agents (HRC) are an increasing problem that limits patients' therapeutic options, needing to change to second line treatments, therefore decreasing quality of life and life expectancy. Fortunately, during the last decade drug desensitization protocols have been developed, allowing patients to receive first line treatment, minimizing risks and increasing life expectancy [1]. Even when patients with severe drug reactions cannot be managed despite adequately modified desensitization protocols, the use of Omalizumab can help to achieve tolerance [2]. Common classification for drug hypersensitivity reactions (HSRs) corresponds to Gell and Coombs classification: Type I (IgE mediated), Type II, (antibody mediated cytotoxicity reactions), Type III (immune complex-mediated reactions), and Type IV for delayed type hypersensitivity [3]. However, this classification does not correlate with actual spectrum of reactions experienced by some patients with HSRs [4,5] reason why a new approach based on precision medicine through phenotypes, endotypes and biomarkers has been proposed [3-7] encompassing the classic HSRs and reactions that do not correspond to this classification [7].

Background: The pandemic caused by Coronavirus disease 2019, has caused great impact worldwide. Risk factors for severe outcomes have been identified, but asthma seems not to be one of them. Objectives: Our principal purpose is to analyze personal characteristics in severe asthma patients, in treatment with monoclonal antibody, belonging to the Health Department of Castellon, in order to see if these variables affect the probability of being infected by SARS-Cov-2. Methods: This is an observational study. Patients recruited had severe asthma in treatment with monoclonal antibody. A questionnaire was elaborated. Aspects evaluated were: COVID-19 symptoms, asthma control, exposition to the disease, and lifestyle before the pandemic. Serological tests were done by using total SARS-Cov-2 antibody test. Results: 108 patients were enrolled in the study, of whom 106 patients were included. 11 patients declared suggestive COVID-19 symptoms. A total of 21 patients had a serology test done, giving positive results 2 of them. 27 patients needed medical attention, being asthma exacerbation the most common symptom. 71,7% of patients had a normal or high level of social activity before the pandemic. Statistic significance was achieved for medical assistance, asthma control and contact with SARS-Cov-2 positive patients. Conclusion: Personal external factors in severe asthma patients do not influence the probability of being affected by the disease. We can hypothesize that these patients do not have an increased susceptibility for being infected by the virus. Bad asthma control was the main reason for medical assistance during the pandemic.

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Background: The Coronavirus disease 2019 caused by SARS-CoV2 virus has rapidly spread worldwide becoming one of the most important challenges humans are facing nowadays. Risk factors for severe outcomes have been identified, but asthma seems not to be one of them. Objectives: To analyze lifestyle before the pandemic in severe pediatric asthma patients in treatment with a monoclonal antibody, belonging to Castellon's Universitary General Hospital Health's Department, and investigate the prevalence of COVID-19 in these patients in order to see if their lifestyle may have influenced the probability of being infected by COVID-19. Methods: A questionnaire was developed asking about: their lifestyle before the pandemic; suggestive COVID-19 symptoms and exposition to the disease; and patients' behavior, asthma control and treatment during the pandemic. Total SARS-Cov-2 antibody tests were performed to all patients. Results: A total of 15 patients were included. All patients had a high social exposure before the pandemic. 2 patients had direct contact with positive COVID-19 patients. Both experienced mild symptoms that could be attributed to the disease, but neither of them had a positive serological test. Most patients followed asthma treatment correctly before and during the pandemic. 13 patients referred good asthma control. Most patients continued monthly monoclonal antibody administration. Serological tests were negative for all patients. Conclusion: Severe asthma pediatric patients in treatment with MAB, do not have an increased susceptibility for being infected by the virus, but in the case that they contracted the disease, evidence says they would have shown very weak symptoms.