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- Title
A new non-dilution rapid desensitization protocol successfully applied to all-grade platinum hypersensitivity.
- Authors
Chung, Soo Jie; Kang, Sung-Yoon; Kang, Rae-Young; Kim, Young-Chan; Lee, Kyung-Hun; Kim, Tae-Yong; Han, Sae-Won; Kang, Hye-Ryun
- Abstract
<bold>Purpose: </bold>Desensitization is a safe alternative for patients with hypersensitivity reactions (HSRs) to platinum-based chemotherapeutic agents and widely used in real practice by employing stepwise administration of multiple serial dilutions of the culprit drugs. However, its labor-intensive nature has required a simpler protocol that is easier to prepare and perform.<bold>Methods: </bold>We performed an observational study of patients with platinum HSR who underwent a new non-dilution one-bag desensitization protocol. Premedication consisted of Montelukast as well as H1 and H2 blockers. The outcomes and safety profiles of a new protocol were assessed.<bold>Results: </bold>A total of 36 patients were recruited (oxaliplatin 23, carboplatin 9, and cisplatin 4) and the most common grade of HSR presented was grade 2 (61.1%), followed by grade 3 (25%), and grade 1 (13.9%). Of 175 desensitization procedures, all cases were successfully completed in re-administration of culprit chemotherapeutic platinum agents; 146 (83.4%) had no breakthrough reactions (BTRs) while 29 (16.6%) did. Most BTRs were mild reactions (grade 1, 51.7%) or moderate reactions (grade 2, 44.8%) of Brown's Scale. Although there was one case of asymptomatic mild hypotension (grade 3, 3.5%), categorized as severe reaction, dyspnea, desaturation, and anaphylaxis did not occur. The proportion of severe HSRs was significantly lower than that of initial HSRs (3.5% vs. 25%, P = 0.0167).<bold>Conclusions: </bold>The new non-dilution desensitization protocol was safe and effective for re-administration of culprit platinum agents in patients with a history of HSRs. Therefore, this new protocol can be used as an alternative to existing protocols using multiple serial dilutions.
- Subjects
PLATINUM; ALLERGIES; DRUG allergy; ANTINEOPLASTIC agents; ALLERGY desensitization; IMMUNOLOGIC diseases; DRUG side effects
- Publication
Cancer Chemotherapy & Pharmacology, 2018, Vol 82, Issue 5, p777
- ISSN
0344-5704
- Publication type
journal article
- DOI
10.1007/s00280-018-3662-0