Paclitaxel-associated hypersensitivity reactions: experience of the gynecologic oncology program of the Cleveland Clinic Cancer Center.
OBJECTIVE
: This study expands the existing limited data as to whether patients developing clinically significant paclitaxel-induced hypersensitivity reactions can continue to be treated with this important antineoplastic agent and how such retreatment might be undertaken.


METHODS
More than 450 patients received paclitaxel, either as a single agent or in a combination regimen, for a female pelvic malignancy in the Gynecologic Oncology Program of the Cleveland Clinic Cancer Center from January 1995 through December 1998.


RESULTS
Of the more than 450 patients, 44 (approximately 9%) developed at least one episode of a clinically relevant hypersensitivity reaction to the cytotoxic drug. All 43 individuals (plus an additional four patients referred to our center after having previously experienced a severe paclitaxel-associated hypersensitivity reaction at another institution) who were retreated with paclitaxel were ultimately able to receive the agent. Five patients required treatment with a standardized desensitization regimen, developed by our group, to successfully receive paclitaxel.


CONCLUSIONS
On the basis of this large single-institution study of paclitaxel-associated hypersensitivity reactions, we conclude that with appropriate precautions essentially all individuals experiencing these reactions can be safely treated with this agent.
Markman
M
M
The Cleveland Clinic Taussig Cancer Center, Department of Gynecology, Celveland, Ohio, USA.
Kennedy
A
A
Webster
K
K
Kulp
B
B
Peterson
G
G
Belinson
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003888:Desensitization, Immunologic / Q000379:methods*; D003907:Dexamethasone / Q000627:therapeutic use; D004155:Diphenhydramine / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D015738:Famotidine / Q000627:therapeutic use; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use; D006634:Histamine H1 Antagonists; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects*; D011292:Premedication
D005938:Glucocorticoids; D006634:Histamine H1 Antagonists; D006635:Histamine H2 Antagonists; D015738:Famotidine; D003907:Dexamethasone; D004155:Diphenhydramine; D017239:Paclitaxel