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A New Practical Desensitization Protocol for Oxaliplatin-Induced Immediate Hypersensitivity Reactions: A Necessary and Useful Approach

 Park HJ  ;  Lee JH  ;  Kim SR  ;  Kim SH  ;  Park KH  ;  Lee CK  ;  Kang BD  ;  Beom SH  ;  Shin SJ  ;  Jung M  ;  Park JW 
 Journal of Investigational Allergology and Clinical Immunology, Vol.26(3) : 168-176, 2016 
Journal Title
 Journal of Investigational Allergology and Clinical Immunology 
Issue Date
Adult ; Antineoplastic Agents/adverse effects* ; Drug Hypersensitivity/etiology ; Female ; Humans ; Hypersensitivity, Immediate/chemically induced* ; Male ; Middle Aged ; Organoplatinum Compounds/adverse effects* ; Skin Tests
Chemotherapy ; Cisplatin ; Desensitization ; Hypersensitivity ; Oxaliplatin ; Platinum ; Skin test
BACKGROUND AND OBJECTIVE: Desensitization protocols for patients with immediate hypersensitivity reactions (IHSRs) have proven to be effective, but they are not widely used in clinical practice because of impracticalities such as high cost, long procedure duration, and a lack of trained personnel. We aimed to determine the clinical characteristics of oxaliplatin-induced IHSRs and assess measures to protect against these reactions and to validate a new practical desensitization protocol. METHODS: We retrospectively reviewed 2640 cases of oxaliplatin IHSRs in 271 oxaliplatin users and prospectively used a newly designed desensitization protocol 32 times in 12 patients with hypersensitivity to platinum-based chemotherapy. The protocol consisted of increases in infusion rate every 15 minutes, regardless of the concentration of the chemotherapy agent in the infusion bags. RESULTS: Of the 271 patients administered oxaliplatin, 45 (16.6%) experienced IHSRs. Of 39 patients who experienced an IHSR but needed to continue oxaliplatin, 6 (15.4%) stopped treatment due to the reaction, and 33 (84.6%) continued despite the risk of further reactions. The new desensitization protocol was successfully completed in 12 patients (100%), but it was ineffective in 3 patients (all with a negative skin prick test), who experienced fever without urticaria. CONCLUSIONS: Many patients who experience oxaliplatin-induced IHSRs are required to stop first-line oxaliplatin-based chemotherapy or to continue without desensitization, with the associated risks. Our new desensitization protocol is practical and easy to use in clinical practice.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Kyung Hee(박경희) ORCID logo https://orcid.org/0000-0003-3605-5364
Park, Jung Won(박중원) ORCID logo https://orcid.org/0000-0003-0249-8749
Park, Hye Jung(박혜정) ORCID logo https://orcid.org/0000-0002-1862-1003
Beom, Seung Hoon(범승훈) ORCID logo https://orcid.org/0000-0001-7036-3753
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Lee, Jae Hyun(이재현) ORCID logo https://orcid.org/0000-0002-0760-0071
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
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