title: Evaluation and management of hypersensitivity reactions to chemotherapy agents.
abstract: Hypersensitivity reactions to chemotherapy drugs pose significant difficulties in management, especially when no suitable alternative is available or acceptable and delay in continuation of treatment may be life-threatening. Such reactions may be IgE- or non-IgE-mediated and have varied manifestations. Timely recognition and treatment of life-threatening hypersensitivity reactions are essential. Identification of patients at high risk of developing hypersensitivity reactions allows risk stratification to guide clinical decision-making. Skin testing for carboplatin hypersensitivity has good predictive value but is not yet established for oxaliplatin and taxane hypersensitivity. Rapid desensitisation may be considered if no suitable alternative drug is available. Available protocols have shown good safety and efficacy but must be performed in an appropriate setting with adequate monitoring. There are many avenues for research into the utility of skin testing for other chemotherapy agents as well as in vitro tests.
authors: University Children's Medical Institute, National University Hospital, Singapore, Singapore Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors: Elizabeth Huiwen
authors: EH
authors: Tham
authors: Department of Allergy, Arthritis & Rheumatism Clinic, Gleneagles Medical Centre, Singapore, Singapore.
authors: Yew Kuang
authors: YK
authors: Cheng
authors: Oncocare Clinic, Gleneagles Medical Centre, Singapore, Singapore.
authors: Miah Hiang
authors: MH
authors: Tay
authors: University Children's Medical Institute, National University Hospital, Singapore, Singapore Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors: Ana Patricia
authors: AP
authors: Alcasabas
authors: University Children's Medical Institute, National University Hospital, Singapore, Singapore Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors: Lynette Pei-Chi
authors: LP
authors: Shek
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000276:immunology; D001952:Bridged-Ring Compounds / Q000009:adverse effects / Q000276:immunology*; D002945:Cisplatin / Q000009:adverse effects / Q000276:immunology*; D003888:Desensitization, Immunologic; D004306:Dose-Response Relationship, Immunologic; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D012017:Referral and Consultation; D012307:Risk Factors; D012882:Skin Tests; D043823:Taxoids / Q000009:adverse effects / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane; D002945:Cisplatin