Hypersensitivity reactions to oxaliplatin: a case report and the success of a continuous infusional desensitization schedule
- 1 July 2004
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Anti-Cancer Drugs
- Vol. 15 (6), 605-607
- https://doi.org/10.1097/01.cad.0000132235.38297.7c
Abstract
Oxaliplatin is a third-generation platinum analog that is used mainly to treat advanced colorectal cancer. The reported incidence of hypersensitivity reactions to oxaliplatin, especially after multiple cycles of therapy, is less than 1%. We report a patient with metastatic colon cancer who developed a hypersensitivity reaction to oxaliplatin during the sixth cycle of combination chemotherapy with oxaliplatin, high-dose 5-fluorouracil and leucovorin. The same reaction occurred again after re-exposure to oxaliplatin 2 weeks later even with prophylactic administration of steroids and H1 antihistamines. After failing third-line treatment with oral tegafur-uracil, we desensitized the patient by using a fixed-rate 24-h continuous infusion of dilute oxaliplatin (0.15 mg/ml), in addition to steroids and H1 antihistamines. He had no hypersensitivity reaction during or after that infusion or when the same concentration was infused in the same way 2 weeks later. Because his condition subsequently deteriorated and the cancer progressed, no further oxaliplatin was given. Our experience does demonstrate, however, that a fixed-rate 24-h continuous infusion of oxaliplatin in a low concentration may prevent a hypersensitivity reaction in a previously sensitized patient.Keywords
This publication has 18 references indexed in Scilit:
- Hypersensitivity and idiosyncratic reactions to oxaliplatinCancer, 2003
- Skin testing and hypersensitivity reactions to oxaliplatinAnnals Of Oncology, 2003
- Hypersensitivity Reactions to Oxaliplatin: Cross-Reactivity to Carboplatin and the Introduction of a Desensitization ScheduleJournal of Clinical Oncology, 2002
- Hypersensitivity Reactions to Carboplatin Administration Are Common but Not Always Severe: A 10-Year ExperienceOncology, 2001
- Idiosyncratic reaction after oxaliplatin infusionAnnals of Oncology, 2001
- Phase III Multicenter Randomized Trial of Oxaliplatin Added to Chronomodulated Fluorouracil–Leucovorin as First-Line Treatment of Metastatic Colorectal CancerJournal of Clinical Oncology, 2000
- Clinical Features of Hypersensitivity Reactions to CarboplatinJournal of Clinical Oncology, 1999
- Oxaliplatin in practiceBritish Journal of Cancer, 1998
- Oxaliplatin with high-dose leucovorin and 5-fluorouracil 48-hour continuous infusion in pretreated metastatic colorectal cancerEuropean Journal Of Cancer, 1997
- Hypersensitivity and cross-reactivity to cisplatin and analoguesCancer Chemotherapy and Pharmacology, 1995