title: Paclitaxel-associated hypersensitivity reactions: experience of the gynecologic oncology program of the Cleveland Clinic Cancer Center.
abstract: 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.
authors.affiliation: The Cleveland Clinic Taussig Cancer Center, Department of Gynecology, Celveland, Ohio, USA.
authors.forename: M
authors.initials: M
authors.lastname: Markman
authors.forename: A
authors.initials: A
authors.lastname: Kennedy
authors.forename: K
authors.initials: K
authors.lastname: Webster
authors.forename: B
authors.initials: B
authors.lastname: Kulp
authors.forename: G
authors.initials: G
authors.lastname: Peterson
authors.forename: J
authors.initials: J
authors.lastname: Belinson
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D006634:Histamine H1 Antagonists; D006635:Histamine H2 Antagonists; D015738:Famotidine; D003907:Dexamethasone; D004155:Diphenhydramine; D017239:Paclitaxel