title: Successful desensitization to oxaliplatin with incorporation of calcium gluconate and magnesium sulfate.
abstract: Since the results of the MOSAIC trial demonstrated an improved disease-free survival in stage III colorectal patients treated with oxaliplatin combined with 5-fluorouracil and folinic acid when they were compared with those treated with 5-fluorouracil and folinic acid alone, the addition of this organoplatin to 5-fluorouracil and folinic acid has become first-line adjuvant treatment for stage III colorectal cancer. Unfortunately, there is a small population of patients who develop grade III/IV hypersensitivity reactions to oxaliplatin which, until recently, have interfered with further treatment with oxaliplatin-containing regimens. Successful oxaliplatin desensitization protocols for patients having severe oxaliplatin hypersensitivity reactions have been reported. However, none of these protocols, have incorporated magnesium and calcium salts. Retrospective data has suggested that pretreating colorectal cancer patients with magnesium sulfate and calcium gluconate before the administration of oxaliplatin may reduce the incidence of neurotoxicities induced by this drug. Therefore, we modified a previously published oxaliplatin-desensitization protocol by incorporating intravenous calcium gluconate and magnesium sulfate, and report a patient with stage IIIc colorectal cancer and prior severe hypersensitivity reactions to oxaliplatin who underwent successful oxaliplatin desensitization using this protocol.
authors.affiliation: Yale New Haven Hospital and Yale University School of Medicine, New Haven, Connecticut 06520, USA.
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Wrzesinski
authors.forename: Meghan L
authors.initials: ML
authors.lastname: McGurk
authors.forename: Constance T
authors.initials: CT
authors.lastname: Donovan
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Ferencz
authors.forename: Muhammad Wasif
authors.initials: MW
authors.lastname: Saif
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002125:Calcium Gluconate / Q000008:administration & dosage / Q000627:therapeutic use*; D004342:Drug Hypersensitivity / Q000517:prevention & control*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000627:therapeutic use*; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000077150:Oxaliplatin; D012811:Sigmoid Neoplasms / Q000188:drug therapy / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D008278:Magnesium Sulfate; D002955:Leucovorin; D002125:Calcium Gluconate; D005472:Fluorouracil