Τίτλος:
Clinical Features of Hypersensitivity Reactions to Oxaliplatin: A
10-Year Experience
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Oxaliplatin has become one of the major cytotoxic agents for
the treatment of gastrointestinal tumors. As a result, several cases of
the so-called oxaliplatin-associated hypersensitivity reaction have been
documented. Patients and Methods: We have retrospectively evaluated and
characterized these reactions in our patient group by reviewing the
files of 1,224 patients exposed to an oxaliplatin-containing regimen in
order to provide useful clinical information for diagnosis and
management. Results: Three hundred and eight (308) patients who have
never been exposed to platinum compounds developed symptoms compatible
with a reaction to oxaliplatin that was verified by manifestation of at
least similar symptoms on rechallenging. The reactions occurred after
the first 5 courses, with a median course number of 9 (range 1-24).
These reactions could be distinguished as (1) mild reactions occurring
in 195 (63%) patients manifesting with itching and small area erythema
either during treatment or within the next hours, and (2) severe
reactions occurring in 113 (37%) patients within minutes of drug
infusion manifesting with diffuse erythroderma, facial swelling, chest
tightness, bronchospasm and changes in blood pressure. Oxaliplatin
withdrawal was not required in patients with a mild reaction. Forty-
eight ( 42%) patients having a severe reaction with appropriate
premedication and prolongation of the infusion duration could tolerate
2-4 subsequent courses. For the remaining 65 (58%) patients,
oxaliplatin withdrawal was inevitable because of the very severe
reactions occurring on rechallenging. In addition, 3 patients presented
with thrombocytopenia and 3 others with hemolytic anemia, all reversible
upon oxaliplatin discontinuation. Conclusions: Hypersensitivity
reactions to oxaliplatin are underestimated. Although the reactions are
not frequent during first courses, in extensively pretreated patients,
they may become a serious problem. In the majority of patients, drug
discontinuation might not be necessary. In patients manifesting a severe
reaction, re-exposure to oxaliplatin should be considered only if the
patient can tolerate the reaction and there has been clinical benefit
from this therapy. Physicians and nursing staff should be aware of the
risk and be well prepared. Copyright (C) 2008 S. Karger AG, Basel
Συγγραφείς:
Polyzos, Aristides
Tsavaris, Nikolas
Gogas, Hellen and
Souglakos, John
Vambakas, Lambros
Vardakas, Nikolaos and
Polyzos, Kostas
Tsigris, Christos
Mantas, Demetrios and
Papachristodoulou, Antonios
Nikiteas, Nikolas
Karavokyros, John
G.
Felekouras, Evangelos
Griniatsos, John
Giannopoulos,
Athanasios
Kouraklis, Gregory
Περιοδικό:
DIAGNOSTIC ONCOLOGY
Λέξεις-κλειδιά:
Oxaliplatin; Hypersensitivity reactions; Platinum compound
