Predictors of Hypersensitivity Reactions to Platinum-Based Chemotherapy in a Tertiary Hospital in Oman

Abstract

Objectives: Platinum-based compounds (PBC) play an important role in cancer therapy. However, one of the drawbacks of PBC is the occasional occurrence of hypersensitivity reactions (HSR) which can lead to serious consequences. The aim of the study is to estimate the prevalence and evaluate risk factors of HSR to PBC in cancer patients. Methods: A case-control study of patients who received any PBC for the management of non-haematological cancers from 2013 to 2020 at Sultan Qaboos University Hospital, Oman. Data regarding demographic features and diseases and treatment details were collected from the hospital’s electronic patients record. We quantitatively described the data, and Student’s t-test and Wilcoxon Man-Whittney tests were used to detect significant differences. Results: A total of 38 cases and 148 matched controls were studied. The prevalence of HSR to PBC in our cohort was 4.7% (95% confidence interval: 3.33%-6.37%), more with carboplatin compared to cisplatin and oxaliplatin. In our study, female gender (p=0.032), concomitant taxanes (p=0.002) and concurrent radiation (p<0.001) were significant predictors of HSR to PBC. The majority of reactions were of mild to moderate severity and the rechallenge rate after HSR development was 13%. Conclusion: HSR to PBC impact therapy decisions and understanding the risk factors are important to improve treatment outcomes in cancer patients.
 Keywords: Hypersensitivity; Platinum; Anti-neoplastic; Oncology; Oman.

The Role of the Allergist in the Management of Chemotherapy-Induced Hypersensitivity Reactions

“…Platinum derivetives exert their effects; the DNA adducts induce different cellular responses such as transcription inhibition, cell cycle arrest, DNA repair, and apoptosis [11]. HSRs to platinum agents are common, most patients experience mild reactions but the severity can vary and even lead to death [12].…”