Hypersensitivity reaction to pegylated liposomal doxorubicin administration for Mullerian carcinoma in Japanese women

Abstract

Aim PEGylated liposomal doxorubicin (PLD) is a therapeutic agent for gynecological malignancy. Hypersensitivity reaction (HSR) is a major adverse effect that usually disappears after halting administration of PLD. Premedication is usually not necessary before administration of PLD to prevent HSR. Here, we evaluated the frequency of HSR during administration of PLD following premedication in Japanese women. Methods We performed PLD administration in 78 patients (386 cycles) between 2013 and 2018. Granisetron hydrochloride and dexamethasone sodium phosphate were administered 30 min before PLD administration. Then, PLD (40 or 30 mg/m2 combined usage with carboplatin) was administered. We retrospectively reviewed the medical records of 78 patients and examined the frequency of HSR. Results Seven of 78 (9%) patients showed HSR by PLD administration following premedication. One patient showed cardiopulmonary arrest in 13 min after PLD administration (grade 4). The other six patients showed grade 2 HSR. All patients developed HSR in the first course. The incidence of HSR was significantly higher in patients with allergic history than in patients without allergic history (p = 0.0151). Conclusions Clinicians should be aware of the potential for HSR in patients administered PLD, particularly those with allergic history and those receiving the first cycle of PLD, even following premedication.

Biomarkers of PEGylated Liposomal Doxorubicin-Induced Hypersensitivity Reaction in Breast Cancer Patients Based on Metabolomics

“…In the current study, patients experienced a fairly high incidence rate of HSRs (64.3%). In contrast, research by Alberts et al and Yamaguchi et al (2021) reported very low frequencies of HSRs between 7 and 9% ( Alberts and Garcia, 1997 ). In other research, Gabizon et al (1994) reported a frequency of 25%, while Castells et al (2008) reported that 4 of 5 patients experienced HSR.…”

“…Premedication is usually not necessary before the administration of PLD to prevent HSRs ( Yamaguchi et al, 2021 ). However, the incidence rate of PLD-induced HSR varies widely across existing reports.…”