About the Adverse Drug Reaction and Desensitization Program

Rapid Desensitization Program at Dana-Farber Cancer Institute


Mariana C. Castells, MD, PhD, Director of the Desensitization Program at Dana-Farber/Brigham and Women’s Cancer Center, has developed a comprehensive program that evaluates and cares for all patients with adverse reactions to chemotherapy and monoclonal antibodies, as well as new biological agents. It is the only program nationwide to provide standardized desensitizations with a 12-step protocol.

“Desensitization enables patients to receive and tolerate medications that are most likely to deliver the best outcome,” said Dr. Castells. “Patients can receive multiple desensitizations to complete their required therapy cycle or the participation in clinical studies and can be desensitized to multiple medications.”

With over 200 patients and 900 desensitizations preformed each year, the Desensitization Program provides rapid desensitizations to all patients in need of first-line therapy that has resulted in severe allergic reactions in order to continue treatment. The protocol has been used nationally and internationally to desensitize patients who experience reactions to medications such as carboplatin and other platins, taxol, taxotere and other taxanes, rituximab and other monoclonal therapies, antibiotics, aspirin and other NSAIDs, and many other medications. Dr. Castells has established Desensitization Programs in Europe and Asia and trains national and international allergists in rapid desensitizations. The Program has received national and international recognition for providing improved survival and increased quality-of-life for all patients.

Attending Physicians

  • Mariana Castells, MD, PhD
  • David Sloane, MD
  • David Hong, MD
  • Joyce Hsu, MD
  • Karen Hsu Blatman, MD
  • Katherine Cahill, MD
  • Lora Bankova, MD
  • Laura Fanning, MD


  • Jared Silver, MD
  • Kathleen Buchheit, MD
  • Parul Kothari, MD
  • Matthew Giannetti, MD

Desensitization Nurse Practitioner

  • Donna-Maria Lynch, FNP-BC

Desensitization Coordinator

  • Sherwood Alexis

Related Publications

Del Carmen Sancho-Serra M, Simarro M, Castells M. Rapid IgE desensitization is antigen specific and impairs early and late mast cell responses targeting FcεRI internalization. Eur J Immunol. 2011 Apr;41(4):1004-13.

Castells MC. Anaphylaxis and Hypersensitivity Reactions. Castells MC, editor. Humana Press, Springer Science+Business Media, LLC New York; 2011.

Farber MK, Angelo TE, Castells M, Tsen LC. Anesthetic management of a patient with an allergy to propylene glycol and parabens. Anesth Analg. 2010 Mar 1;110(3):839-42.

Limsuwan T, Castells MC. Outcomes and safety of rapid desensitization for chemotherapy hypersensitivity. Expert Opin Drug Saf. 2010 Jan;9(1):39-53. Review.

Brennan PJ, Rodriguez Bouza T, Hsu FI, Sloane DE, Castells MC. Hypersensitivity reactions to mAbs: 105 desensitizations in 23 patients, from evaluation to treatment. J Allergy Clin Immunol. 2009 Dec;124(6):1259-66.

Legere HJ 3rd, Palis RI, Rodriguez Bouza T, Uluer AZ, Castells MC. A safe protocol for rapid desensitization in patients with cystic fibrosis and antibiotic hypersensitivity. J Cyst Fibros. 2009 Dec;8(6):418-24.

Castells M. Rapid desensitization for hypersensitivity reactions to medications. Immunol Allergy Clin North Am. 2009 Aug;29(3):585-606. Review.

Castells MC, Tennant NM, Sloane DE, Hsu FI, Barrett NA, Hong DI, Laidlaw TM, Legere HJ, Nallamshetty SN, Palis RI, Rao JJ, Berlin ST, Campos SM, Matulonis UA. Hypersensitivity reactions to chemotherapy: outcomes and safety of rapid desensitization in 413 cases. J Allergy Clin Immunol. 2008 Sep;122(3):574-80.


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