Hypersensitivity reactions to antineoplastic agents: an overview

Syrigou, Ekaterini; Makrilia, Nektaria; Koti, I.; Saif, Muhammad Wasif; Syrigos, Kostas

doi:10.1097/cad.0b013e32831961b3

Cited by 53 publications

(42 citation statements)

References 33 publications

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“…Even though the pathophysiology of HSR to DT is unclear, several mechanisms have been proposed [25]. Sometimes these reactions may develop after multiple infusions, suggesting the need for sensitization.…”

Section: Discussionmentioning

confidence: 99%

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Hypersensitivity Reactions to Docetaxel: Retrospective Evaluation and Development of a Desensitization Protocol

Syrigou¹,

Dannos²,

Κοττέας³

et al. 2011

Int Arch Allergy Immunol

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Background: Docetaxel (DT) is an extensively used taxane, frequently associated with hypersensitivity reactions. The aim of this study was to record the epidemiological and clinical features of hypersensitivity to DT in non-small cell lung cancer patients in order to obtain useful information concerning the management of these patients. We also developed a desensitization protocol and evaluated its clinical application. Methods: We retrospectively reviewed records of 620 non-small cell lung cancer patients treated with DT-containing regimens in the adjuvant, first-, second- or next-line setting. Data from 102 patients who had exhibited hypersensitivity reactions were analyzed according to the Common Toxicity Criteria for Adverse Events version 3.0. Five patients were chosen for the desensitization protocol. We applied the standard protocol for parenteral desensitization to β-lactam antibiotics, and DT treatment was carried out with a series of 10-fold dilutions in sufficient volume to administer the total dose. Results: One hundred and two patients (16.5%) were recorded as having hypersensitivity to DT. Reactions were observed after approximately 2.5 ± 1.0 cycles. Only 14 patients (14/620, 2%) developed grade 3–4 hypersensitivity. Reactions were more likely in patients during second- or third-line chemotherapy, but no other correlation (age, gender, atopic status) was observed. Five patients completed a parenteral desensitization protocol and continued their treatment uneventfully. Conclusions: Hypersensitivity reactions to DT respond quickly to discontinuation along with appropriate supportive care. Premedication and increased infusion time may allow readministration. The desensitization protocol that we developed provides a reliable alternative to permanent discontinuation of DT.

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Section: Discussionmentioning

confidence: 99%

“…All data were collected on a SPSS 11.5 database. Skin tests (prick and intradermal) were not performed because DT is considered to be toxic when in touch with the skin [25,26]. However, prick tests with late readings after 24 h have been reported in the past without toxicity [27].…”

Section: Methodsmentioning

confidence: 99%

Hypersensitivity Reactions to Docetaxel: Retrospective Evaluation and Development of a Desensitization Protocol

Syrigou¹,

Dannos²,

Κοττέας³

et al. 2011

Int Arch Allergy Immunol

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“…The rate of HR associated with paclitaxel regimens is up to 30% without premedication therapy and 2–4% with premedication (steroids and antihistamines) [2,14]. Although there are reports suggesting that a history of allergies increases the incidence of HR to paclitaxel, no IgE-mediated mechanism has been established.…”

Section: Discussionmentioning

confidence: 99%

A Search for Predictive Factors for Hypersensitivity Reactions to Paclitaxel and Platinum Salts in Chemotherapy for Gynecologic Pelvic Neoplasms

Piovano

Pivetta

Modaffari

et al. 2012

Gynecol Obstet Invest

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Aims: To investigate the frequency of and predictive factors for hypersensitivity reactions (HR) to taxanes and platinum salts in a cohort of patients treated for pelvic gynecologic malignancies. Methods: The medical records of all patients with gynecologic pelvic neoplasms treated with chemotherapy at the Department of Gynecologic Oncology, AO Mauriziano Umberto I of Turin, from September 2007 through August 2008, were retrospectively reviewed. Two multivariate models, regarding carboplatin and taxane chemotherapy, respectively, were performed to evaluate the potential predictive value of various clinical features. Results: The incidence of HR was 14% (22/157). Multivariate models showed that menopausal women had a significantly lower probability of HR (OR 0.12, CI 0.02–1.13, p = 0.06 for the carboplatin model and OR 0.05, CI 0.01–0.63, p = 0.02 for the taxane model) while a history of systemic hypersensitivity was associated with a higher but non-significant risk of HR (OR 2.64, CI 0.78–8.95, p = 0.11, for the carboplatin model and OR 3.42, CI 0.94–12.45, p = 0.06, for the taxane model). Conclusion: We confirmed a history of hypersensitivity as a risk factor for HR. Other larger cohorts should be analyzed: we need to find new predictive factors in order to select women who should be submitted to experimental prophylactic strategies.

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“…Hypersensitivity reactions of varying mechanisms are well documented with chemotherapeutic agents in humans (ChananKhan et al 2003, Syrigou et al 2009, Castells Guitart 2014. Given that the reaction in this case occurred during the second infusion, it is possible that the first dose "sensitized" the cat to the drug and the reaction constituted an antibody-mediated reaction.…”

Section: Hypersensitivity Reaction During Epirubicin Infusion In a Catmentioning

confidence: 99%

Hypersensitivity reaction during epirubicin infusion in a cat

Elliott

2015

J of Small Animal Practice

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LETTERWhile the risk, is deemed low, cats should be monitored closely for infusion-related reactions when epirubicin is administered as hypersensitivity reactions can be serious and require urgent intervention. It may also be prudent to consider a slower rate of drug infusion. If a reaction occurs then drug administration should be discontinued and treatment with H1-antagonists, corticosteroids and/or adrenaline given, depending on severity. Infusion could be continued if the reaction was mild and the clinical signs controlled but this will be case-dependent. The current case suggests that further doses of epirubicin may be administered after hypersensitivity has been observed following H1 blockade. Further studies would however be required to corroborate this. Given the seemingly low incidence of hypersensitivity during epirubicin infusions in cats, it is not believed that routine premedication is necessary at this time.

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Hypersensitivity reactions to antineoplastic agents: an overview

Cited by 53 publications

References 33 publications

Hypersensitivity Reactions to Docetaxel: Retrospective Evaluation and Development of a Desensitization Protocol

Hypersensitivity Reactions to Docetaxel: Retrospective Evaluation and Development of a Desensitization Protocol

A Search for Predictive Factors for Hypersensitivity Reactions to Paclitaxel and Platinum Salts in Chemotherapy for Gynecologic Pelvic Neoplasms

Hypersensitivity reaction during epirubicin infusion in a cat

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