Hypersensitivity and cross-reactivity to cisplatin and analogues

Shlebak, Abdul; Clark, Peter; Green, J. A.

doi:10.1007/bf00689458

Cited by 51 publications

(21 citation statements)

References 12 publications

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“…Regarding the mechanism of hypersensitivity reactions to oxaliplatin, as in the cases of other platinum agents, the prolonged period of sensitization and the rapid onset of symptoms would support a type I IgE-mediated mechanism [10, 12, 14]. Another hypothesis suggests an expansion of T cells induced by platinum agents that act as antigens; they can trigger the release of preinflammatory cytokines such as IL-6, tumor necrosis factor-a and interferon-γ [24].…”

Section: Discussionmentioning

confidence: 99%

“…The range of its toxicity varies from acute reversible sensory cold-sensitive dysesthesia to cumulative and dose-limiting peripheral neurotoxicity [8, 9]. Hypersensitivity reactions to oxaliplatin unlike other platinum compounds such as cisplatin and carboplatin, where the incidence varies from 17 to 27%, have only sporadically been described in the past [10,11,12]. In the last years, oxaliplatin has been extensively used and, as a result, several cases of the so-called oxaliplatin-associated hypersensitivity reaction have been documented [13,14,15,16,17,18].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features of Hypersensitivity Reactions to Oxaliplatin: A 10-Year Experience

Polyzos

Tsavaris²,

Gogas³

et al. 2008

Oncology

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Features of Hypersensitivity Reactions to Oxaliplatin: A 10-Year Experience

Polyzos

Tsavaris²,

Gogas³

et al. 2008

Oncology

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“…Moreover, cisplatin and carboplatin, used in the treatment of a number of neoplasms, can provoke type 1 hypersensitivity reactions [3]. …”

Section: Discussionmentioning

confidence: 99%

“…It is well-known that the other platinum coordination complexes, cisplatin and carboplatin, can cause hypersensitivity reactions of varying severity with an incidence even of over 5% [3]. Hypersensitivity reactions to oxaliplatin are now being reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

Standardization of Skin Tests for Diagnosis and Prevention of Hypersensitivity Reactions to Oxaliplatin

Pagani¹,

Bonadonna

Senna

et al. 2007

Int Arch Allergy Immunol

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Background: Platinum salts can cause allergic sensitization. Recently, hypersensitivity reactions to oxaliplatin, the most recent platinum coordination complex introduced into clinical practice, have been reported. Objective: To validate and standardize skin tests to diagnose and possibly prevent hypersensitivity reactions to oxaliplatin. The secondary aims were to confirm IgE-mediated pathogenesis of the clinical manifestations and to evaluate skin tests to predict patients at risk of hypersensitivity reactions to oxaliplatin. Methods: We performed skin tests atincreasing concentrations of oxaliplatin on 15 patients never exposed to platinum salts, on 10 patients treated with oxaliplatin without any adverse reactions, and on 4 patients who had shown hypersensitivity reactions to the drug. Moreover we performed skin tests on 8 additional patients starting before the 5th dose and following a course of chemotherapy. Results: A positive skin reaction to the prick test at a concentration of 1 mg/ml was seen in 1 patient with hypersensitivity reactions. The intradermal test was positive in all the patients with hypersensitivity reactions at a concentration of 0.1 mg/ml. It was negative in the 15 nonexposed subjects, and in the 10 patients who had been exposed to oxaliplatin without hypersensitivity reactions. The skin test administered to patients before chemotherapy was positive in one case. Conclusion: A skin prick test at a concentration of 1 mg/ml and, in the case of a negative response, an intradermal test at the optimal concentration of 0.1 mg/ml should be used, starting from the 5th course of therapy, to diagnose and prevent hypersensitivity reactions to oxaliplatin.

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“…Hauptanwendungsgebiete sind Karzinome im gynäkologischen Bereich sowie Hoden-und Bronchialkarzinome [11]. Die Wahrscheinlichkeit einer allergischen Reaktion nach Applikation von Carboplatin wird in aktuellen Publikationen auf 5-34% geschätzt [6].…”

Section: Introductionunclassified

Basophilenaktivierungstest als In-vitro-Assay bei Platinsalzallergie

2008

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During chemoembolization with gemcitabine, mitomycin and cisplatin of a cholangiocellular carcinoma and after receiving iodide contrast media, a 49-year-old patient developed a grade III anaphylactic reaction. We were asked to verify an adverse reaction to contrast media. Using the basophil activation test, we demonstrated a hypersensitivity reaction to cisplatin with distinct induction of CD63-expression on basophilic granulocytes.

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Hypersensitivity and cross-reactivity to cisplatin and analogues

Cited by 51 publications

References 12 publications

Clinical Features of Hypersensitivity Reactions to Oxaliplatin: A 10-Year Experience

Clinical Features of Hypersensitivity Reactions to Oxaliplatin: A 10-Year Experience

Standardization of Skin Tests for Diagnosis and Prevention of Hypersensitivity Reactions to Oxaliplatin

Basophilenaktivierungstest als In-vitro-Assay bei Platinsalzallergie

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