title: Hypersensitivity to oxaliplatin: clinical features and risk factors.
abstract: BACKGROUND
  Oxaliplatin-based regimens induce a potential risk of hypersensitivity reaction (HSR), with incidence varying from 10% to 25% and lack of clearly identified risk factors. The present study aimed to assess incidence and risk factors in HSR.
  
  
  METHODS
  All patients treated with oxaliplatin in the Medical Oncology Department of the Lyon Sud University Hospital (Hospices Civils de Lyon, France) from October 2004 to January 2011 were enrolled. Incidence and severity of HSR were analyzed retrospectively and the potential clinicopathological covariates were tested on univariate and multivariate analysis.
  
  
  RESULTS
  A total of 1,221 doses of oxaliplatin were administered for 191 patients, 8.9% of whom experienced an HSR. Seventeen HSRs were observed, with 1.6% grade 3 and no grade 4 events. The first reaction appeared after a median of 3 oxaliplatin infusions. Using univariate analysis, HSR was associated with younger age (mean age, 56.2 years; p = 0.04), female gender (p = 0.01) and prior exposure to platinum salts (p = 0.02). No increased risk was associated with mean dose or with presence of atopic background. Multivariate analysis confirmed that women were at higher risk of oxaliplatin HSR than men (p < 0.05). Reintroduction of oxaliplatin was effective in 64.7% of hypersensitive patients using an appropriate premedication strategy. Patients who experienced a grade 3 HSR were not rechallenged.
  
  
  CONCLUSIONS
  The risk of developing oxaliplatin HSR should not be underestimated (8.9% of patients). The medical team's vigilance should be increased with women, younger patients and patients with prior exposure to platinum salts.
authors.forename: Marie
authors.initials: M
authors.lastname: Parel
authors.forename: Florence
authors.initials: F
authors.lastname: Ranchon
authors.forename: Audrey
authors.initials: A
authors.lastname: Nosbaum
authors.forename: Benoit
authors.initials: B
authors.lastname: You
authors.forename: Nicolas
authors.initials: N
authors.lastname: Vantard
authors.forename: Vérane
authors.initials: V
authors.lastname: Schwiertz
authors.forename: Chloé
authors.initials: C
authors.lastname: Gourc
authors.forename: Noémie
authors.initials: N
authors.lastname: Gauthier
authors.forename: Marie-Gabrielle
authors.initials: MG
authors.lastname: Guedat
authors.forename: Sophie
authors.initials: S
authors.lastname: He
authors.forename: Eléna
authors.initials: E
authors.lastname: Kiouris
authors.forename: Céline
authors.initials: C
authors.lastname: Alloux
authors.forename: Thierry
authors.initials: T
authors.lastname: Vial
authors.forename: Véronique
authors.initials: V
authors.lastname: Trillet-Lenoir
authors.forename: Gilles
authors.initials: G
authors.lastname: Freyer
authors.forename: Frédéric
authors.initials: F
authors.lastname: Berard
authors.affiliation: Hospices Civils de Lyon, Clinical Oncology Pharmacy Department, Pierre-Bénite - Université Lyon 1, EMR 3738, Lyon, France. catherine.rioufol@chu-lyon.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Rioufol
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D000077150:Oxaliplatin; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin