دورية أكاديمية
Rapid drug desensitization with platin-based chemotherapy: Analysis of risk factors for breakthrough reactions.
| العنوان: | Rapid drug desensitization with platin-based chemotherapy: Analysis of risk factors for breakthrough reactions. |
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| المؤلفون: | Gorgulu Akin B; Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey., Erkoc M; Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey., Korkmaz ET; Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey., Ozdel Ozturk B; Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey., Colak S; Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey., Ozalp Ates FS; Department of Biostatistics and Medical Informatics, Manisa Celal Bayar University School of Medicine, Manisa, Turkey., Bavbek S; Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey. |
| المصدر: | The World Allergy Organization journal [World Allergy Organ J] 2021 Dec 20; Vol. 15 (1), pp. 100619. Date of Electronic Publication: 2021 Dec 20 (Print Publication: 2022). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101481283 Publication Model: eCollection Cited Medium: Print ISSN: 1939-4551 (Print) Linking ISSN: 19394551 NLM ISO Abbreviation: World Allergy Organ J Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: 2019- : [Atlanta, GA] : Elsevier Inc. Original Publication: [Philadelphia, PA] : Lippincott Williams & Wilkins |
| مستخلص: | Background: All platin-based chemotherapeutics can cause hypersensitivity reactions (HSRs). With rapid drug desensitization (RDD), few patients experience breakthrough reactions (BTR) during desensitization. However, data about risk factors for BTRs during RDD in patients with HSRs to platins are limited. We first aimed to describe characteristics of our platin-reactive population and to validate the Brigham and Women's Hospital's (BWH's) RDD protocol in our population along with their outcomes with RDD. Our second aim was to identify the risk factors for BTRs. Method: This was a retrospective chart review (2013-2020) of patients with symptoms of immediate HSRs to platins. Initial HSRs were classified as grade 1, 2, or 3 based on their severity. Skin prick tests (SPT)/intradermal tests (IDT) were performed with implicated platins. A 12-step protocol was used during RDD. Results: The study comprised 65 women and seven men (mean age 57.78 ± 8.73 years). Initial HSRs to carboplatin, cisplatin, and oxaliplatin occurred in 38, 13, and 21 patients, respectively. All patients reacted at the fifth (median) recurrent infusions (min:1, max:20). The median values for carboplatin, cisplatin, and oxaliplatin were 6 (1-20), 3 (1-15), and 3 (1-11), respectively. Most initial HSRs were grade 2 (n = 40, 55.6%) and 3 (n = 27, 37.5%); only 6.9% (n = 5) were grade 1. Patients with grade 1, 2, and 3 initial HSRs had positive platin skin test results at rates of 80%, 74%, and 88%, respectively.A total of 232 RDDs were performed in 72 patients and 98.7% of these desensitizations were completed. BTRs occurred in 56 (24.1%) (grade 1 n = 14, 25%; grade 2 n = 32, 57%; grade 3 n = 10, 18%) of these desensitizations. Breakthrough reactions were more severe in patients with positive SPTs or 1:100 or 1:10 dilutions of IDT (p = 0.014). BTR was not observed during RDD in any of the patients with positive 1:1 dilutions of IDT. Positivity on prick or 1:100 or 1:10 IDT increased the risk of BTR 5.058 times. There was no significant association between the risk of BTRs and age, drug cycle, sex, comorbidities, or atopy. Conclusion: In our experience, 98.7% of 232 RDDs to platins were completed successfully, showing that RDD was safe and effective. Drug skin test positivity is a potential marker for identifying high-risk patients who will have BTRs during RDDs to platins. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2021 Published by Elsevier Inc. on behalf of World Allergy Organization.) |
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| فهرسة مساهمة: | Keywords: Breakthrough reaction; Hypersensitivity reactions; Platins; Rapid drug desensitization |
| تواريخ الأحداث: | Date Created: 20220107 Latest Revision: 20220429 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC8703063 |
| DOI: | 10.1016/j.waojou.2021.100619 |
| PMID: | 34992710 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1939-4551 |
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| DOI: | 10.1016/j.waojou.2021.100619 |