Hypersensitivity reactions to oxaliplatin: experience in a single institute.
BACKGROUND
A rising incidence of hypersensitivity reactions to oxaliplatin has been observed as a result of increasing clinical use. Epidemiological and clinical features of these reactions are reviewed.


METHODS
Records of patients treated with a modified FOLFOX regimen from March 1999 to March 2004 were reviewed.


RESULTS
One hundred and eighty patients were identified. Twenty-seven patients (15%) have been labelled as allergic to oxaliplatin, the proportion being higher among those receiving oxaliplatin in palliative second-line or above settings (19.6%) than in adjuvant or palliative first-line settings (10.2%). Some 2.2% of them developed grade 3-4 reactions. The reactions occurred after a mean (+/-SD) of 8.5 (+/-4.2) cycles (range 1-18). Among the 14 patients re-exposed to oxaliplatin, four (28.6%) developed hypersensitivity reaction, in two of whom (14.3%) reactions were grade 3-4 in severity.


CONCLUSIONS
The risk of developing hypersensitivity reactions in patients receiving oxaliplatin should not be underestimated. The risk of developing potentially life-threatening hypersensitivity reactions should be explained to patients in the context of the potential benefits of such therapy. Patients receiving oxaliplatin infusion should be closely monitored. Once a patient develops hypersensitivity reaction to oxaliplatin, re-exposure should only be considered if the reaction is mild and there has been documented clinical benefit from previous doses of this agent.
Siu
S W K
SW
Department of Clinical Oncology, Queen Mary Hospital, Pokfulam, Hong Kong. h9715590@graduate.hku.hk
Chan
R T T
RT
Au
G K H
GK
D000970:Antineoplastic Agents / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D004342:Drug Hypersensitivity / Q000453:epidemiology / Q000209:etiology*; D016903:Drug Monitoring; D006801:Humans; D015994:Incidence; D008499:Medical Records; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D000077150:Oxaliplatin; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012307:Risk Factors
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin