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Hypersensitivity to chemotherapeutics: a cross sectional study with 35 desensitisations

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International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

Chemotherapy is one of the main treatments for lung cancer, and in these patients, discontinuation of treatment due to uncontrollable hypersensitivity reactions (HSRs) is an important problem.

Aim

To determine the frequency of HSRs during chemotherapy and to review current approaches.

Methods

We did a cross sectional study in patients undergoing chemotherapy for lung cancer in a reference chemotherapy unit from January 2012 to January 2013. Patients who developed immediate-HSRs or delayed-HSRs to chemotherapeutics and gave consent were included into study. The effectiveness of a standardised 12-step “rapid drug desensitisation” (RDD) procedure was investigated in patients with immediate-HSRs.

Results

In total, 1,099 cycles of chemotherapy were administered to 292 patients in 1 year. We observed ten HSRs, during ten cycles in ten patients (~3 % of the patients). Two HSRs were delayed-type, eight were immediate-type at grade 1–3. Of those with immediate-type HSR, five patients with grade 2–3, and additional two referred patients with grade 4 HSRs were successfully given their culprit drug in 35 cycles of chemotherapy with 12-step or modified 20-step RDD protocol.

Conclusions

HSRs to chemotherapeutics are not so rare. Premedication alone does not prevent such reactions. The results of RDD treatment look promising for continuing treatment with the culprit chemotherapeutic agent.

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Abbreviations

HSR:

Hypersensitivity reaction

SIR:

Standard infusion reaction

RDD:

Rapid drug desensitisation

SPT:

Skin prick test

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Acknowledgments

We would like to thank our dedicated nurses and laboratory technicians Sirin Barut, Sefika Aksoy, Sultan Ferrahoglu, Nezahat Yeni, Sebile Sezgin for their sincere assistance during RDD and SPT procedures.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Chest Diseases, Ege University Medical School, Izmir, Turkey

    Ozlem Goksel, Tuncay Goksel, Gursel Cok, Haydar Karakus, Feza Bacakoglu & Munevver Erdinc

  2. Department of Medical Oncology, Ege University Medical School, Izmir, Turkey

    Erdem Goker & Ruchan Uslu

Authors
  1. Ozlem Goksel
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  2. Tuncay Goksel
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  3. Gursel Cok
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  4. Haydar Karakus
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  5. Feza Bacakoglu
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  6. Erdem Goker
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  7. Ruchan Uslu
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  8. Munevver Erdinc
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Corresponding author

Correspondence to Ozlem Goksel.

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Goksel, O., Goksel, T., Cok, G. et al. Hypersensitivity to chemotherapeutics: a cross sectional study with 35 desensitisations. Int J Clin Oncol 20, 395–404 (2015). https://doi.org/10.1007/s10147-014-0722-2

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  • DOI: https://doi.org/10.1007/s10147-014-0722-2

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