title: Hypersensitivity to chemotherapeutics: a cross sectional study with 35 desensitisations.
abstract: BACKGROUND
  Chemotherapy is one of the main treatments for lung cancer, and in these patients, discontinuation of treatment due to uncontrollable hypersensitivity reactions (HSRs) is an important problem.
  
  
  OBJECTIVE
  To determine the frequency of HSRs during chemotherapy and to review current approaches.
  
  
  METHODS
  We did a cross sectional study in patients undergoing chemotherapy for lung cancer in a reference chemotherapy unit from January 2012 to January 2013. Patients who developed immediate-HSRs or delayed-HSRs to chemotherapeutics and gave consent were included into study. The effectiveness of a standardised 12-step "rapid drug desensitisation" (RDD) procedure was investigated in patients with immediate-HSRs.
  
  
  RESULTS
  In total, 1,099 cycles of chemotherapy were administered to 292 patients in 1 year. We observed ten HSRs, during ten cycles in ten patients (~3 % of the patients). Two HSRs were delayed-type, eight were immediate-type at grade 1-3. Of those with immediate-type HSR, five patients with grade 2-3, and additional two referred patients with grade 4 HSRs were successfully given their culprit drug in 35 cycles of chemotherapy with 12-step or modified 20-step RDD protocol.
  
  
  CONCLUSIONS
  HSRs to chemotherapeutics are not so rare. Premedication alone does not prevent such reactions. The results of RDD treatment look promising for continuing treatment with the culprit chemotherapeutic agent.
authors: Department of Chest Diseases, Ege University Medical School, Izmir, Turkey, ozlem.goksel@ege.edu.tr.
authors: Ozlem
authors: O
authors: Goksel
authors: Tuncay
authors: T
authors: Goksel
authors: Gursel
authors: G
authors: Cok
authors: Haydar
authors: H
authors: Karakus
authors: Feza
authors: F
authors: Bacakoglu
authors: Erdem
authors: E
authors: Goker
authors: Ruchan
authors: R
authors: Uslu
authors: Munevver
authors: M
authors: Erdinc
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects; D003430:Cross-Sectional Studies; D003888:Desensitization, Immunologic / Q000379:methods*; D000077143:Docetaxel; D003875:Drug Eruptions / Q000209:etiology / Q000628:therapy*; D005047:Etoposide / Q000009:adverse effects; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced / Q000628:therapy*; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000628:therapy*; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed / Q000009:adverse effects; D012882:Skin Tests; D043823:Taxoids / Q000009:adverse effects
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000068437:Pemetrexed; D000077143:Docetaxel; D005047:Etoposide; D016190:Carboplatin