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Patients & Consumers Conditions En Español Find an Allergist / Immunologist Just for Kids New Research Parent Resources Pollen Levels Publications Real Life Stories Request a Speaker School Tools Seniors The Virtual Allergist™ Treatments Search by Condition (A-Z) Search by Topic Allergy & Asthma Issues Educational Brochures Elements of Allergy and Asthma Order Public Education Materials Washington Post Supplement Allergy Shots Drug Guide Sublingual Immunotherapy (SLIT)		SELECTED ARTICLES FROM THE RECENT LITERATURE 2008 10/06/2008 Managing the patient who has had a reaction to a chemotherapeutic agent Summary This study represents the largest series of hypersensitivity reactions to chemotherapeutic drugs. The authors evaluated a desensitization protocol in patients who had experienced hypersensitivity reactions to chemotherapeutic agents. The agents included carboplatin, cisplatin, oxaliplatin, paclitaxel, liposomal doxorubicin, doxorubicin, and rituximab. They used a standardized 12-step protocol for desensitization. The doses were administered intravenously or intraperitoneally. The protocol is summarized in Table 1 and Table 2, seen on Pages 575 and 576. All desensitizations were initially done in a medical intensive care unit, but most subsequent infusions took place in an outpatient setting. Of the 413 desensitizations performed, 94% induced mild or no reactions. There were no life-threatening reactions or deaths during the procedures. Most reactions occurred during the first desensitization. Reactions were more commonly recorded during the last step of the protocol. It is important to note that patients with delayed reactions (greater than 48 hours), serum sickness, Stevens-Johnson Syndrome, or toxic epidermal necrolysis were excluded. Editor's Comment: This article is a very helpful resource for allergists consulted to assist in the readministration of a chemotherapeutic agent in a patient who has experienced a previous reaction. It offers a standardized protocol and a procedure which is documented to be reasonably safe. Reference Castells M, et al. Hypersensitivity reactions to chemotherapy: Outcomes and safety of rapid desensitization in 413 cases.   Back
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