Hypersensitivity and idiosyncratic reactions to oxaliplatin

Rebecca R. Thomas, Mary G. Quinn, Barbara Schuler, Jean L Grem

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

BACKGROUND. Oxaliplatin is a third-generation platinum analog that is used to treat a variety of solid tumors, particularly colorectal carcinoma. Patients may develop hypersensitivity reactions, although this complication occurs infrequently. METHODS. Three patients developed hypersensitivity reactions to oxaliplatin while undergoing treatment on a Phase I trial of oxaliplatin and capecitabine. An Entrez PUBMED search was performed to identify other cases. RESULTS. Two patients experienced the abrupt onset of erythema alone or with pruritis during the 9th and 11th infusions of oxaliplatin, whereas the other patient developed fever and mild dyspnea a few hours after the 9th oxaliplatin infusion. All 3 patients were rechallenged successfully for at least 1 additional oxaliplatin infusion by using oral dexamethasone, 20 mg orally, 6 and 12 hours before the administration of oxaliplatin and by administering intravenously 125 mg of solumedrol, 50 mg of diphenhydramine, and 50 mg of cimetidine 30 minutes before oxaliplatin. The literature review suggests two distinct patterns of reactions: classic hypersensitivity (as experienced by the first two patients) and idiosyncratic reactions (as experienced by the third patient). CONCLUSIONS. Patients who develop mild to moderate hypersensitivity to oxaliplatin may be pretreated with steroids and antagonists of Type 1 and 2 histamine receptors, whereas patients who develop severe reactions are unlikely to tolerate further therapy.

Original languageEnglish (US)
Pages (from-to)2301-2307
Number of pages7
JournalCancer
Volume97
Issue number9
DOIs
StatePublished - May 1 2003

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oxaliplatin
Hypersensitivity
Methylprednisolone Hemisuccinate
Diphenhydramine
Histamine Receptors
Cimetidine

Keywords

  • Allergic reactions
  • Hypersensitivity
  • Idiosyncratic reactions
  • Oxaliplatin
  • Platinum compounds

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Hypersensitivity and idiosyncratic reactions to oxaliplatin. / Thomas, Rebecca R.; Quinn, Mary G.; Schuler, Barbara; Grem, Jean L.

In: Cancer, Vol. 97, No. 9, 01.05.2003, p. 2301-2307.

Research output: Contribution to journalArticle

Thomas, RR, Quinn, MG, Schuler, B & Grem, JL 2003, 'Hypersensitivity and idiosyncratic reactions to oxaliplatin', Cancer, vol. 97, no. 9, pp. 2301-2307. https://doi.org/10.1002/cncr.11379
Thomas, Rebecca R. ; Quinn, Mary G. ; Schuler, Barbara ; Grem, Jean L. / Hypersensitivity and idiosyncratic reactions to oxaliplatin. In: Cancer. 2003 ; Vol. 97, No. 9. pp. 2301-2307.
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