PMID- 23647576
OWN - NLM
STAT- MEDLINE
DCOM- 20131106
LR  - 20140204
IS  - 1398-9995 (Electronic)
IS  - 0105-4538 (Linking)
VI  - 68
IP  - 7
DP  - 2013 Jul
TI  - Hypersensitivity and desensitization to antineoplastic agents: outcomes of 189 
      procedures with a new short protocol and novel diagnostic tools assessment.
PG  - 853-61
LID - 10.1111/all.12105 [doi]
AB  - BACKGROUND: Desensitization to antineoplastic agents is becoming a standard of 
      care. Efforts to establish and improve these techniques are being made at many 
      institutions. Our aims are to evaluate a new rapid desensitization protocol 
      designed to be shorter (approximately 4 h) and safer (reducing hazardous drugs 
      exposure risks) and to assess the oxaliplatin-specific immunoglobulin E (IgE) as 
      a novel diagnostic tool. METHODS: Prospective, observational, longitudinal study 
      with patients who, for a 1-year period, suffered reactions to antineoplastic 
      agents and were referred to the Desensitization Program at Ramon y Cajal 
      University Hospital (RCUH). Patients were included or excluded as desensitization 
      candidates after anamnesis, skin testing, risk assessment, and graded challenge. 
      Specific IgE was determined in oxaliplatin-reactive patients. Candidate patients 
      were desensitized using the new RCUH rapid desensitization protocol. RESULTS: Of 
      189 intravenous rapid desensitizations, 188 were successfully accomplished in the 
      23 patients who met inclusion criteria for desensitization (of 58 referred 
      patients). No breakthrough reactions occurred in 94% of desensitizations, and 
      most breakthrough reactions were mild. In 10 oxaliplatin-reactive patients, 38 
      desensitizations were successfully accomplished. Sensitivity for 
      oxaliplatin-specific IgE was 38% (0.35UI/l cutoff point) and 54% (0.10UI/l cutoff 
      point); specificity was 100% for both cutoff points. CONCLUSIONS: In the hands of 
      a Desensitization Program, managed by drug desensitization experts, this new 
      protocol has proven an effective therapeutic tool for hypersensitivity to several 
      antineoplastic agents (oxaliplatin, carboplatin, paclitaxel, docetaxel, 
      cyclophosphamide, and rituximab); moreover, it improves safety handling of 
      hazardous drugs. We report the first large series of oxaliplatin 
      desensitizations. Oxaliplatin-specific IgE determination could be helpful.
CI  - (c) 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Madrigal-Burgaleta, R
AU  - Madrigal-Burgaleta R
AD  - Allergy Division, Ramon y Cajal University Hospital, Madrid, Spain. 
      rmadbur@hotmail.com
FAU - Berges-Gimeno, M P
AU  - Berges-Gimeno MP
FAU - Angel-Pereira, D
AU  - Angel-Pereira D
FAU - Ferreiro-Monteagudo, R
AU  - Ferreiro-Monteagudo R
FAU - Guillen-Ponce, C
AU  - Guillen-Ponce C
FAU - Pueyo, C
AU  - Pueyo C
FAU - Gomez de Salazar, E
AU  - Gomez de Salazar E
FAU - Alvarez-Cuesta, E
AU  - Alvarez-Cuesta E
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20130506
PL  - Denmark
TA  - Allergy
JT  - Allergy
JID - 7804028
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Organoplatinum Compounds)
RN  - 0 (Pyridines)
RN  - 0 (oxiplatin)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
CIN - Allergy. 2013 Nov;68(11):1482-3. PMID: 24351069
CIN - Allergy. 2013 Nov;68(11):1483-4. PMID: 24498642
MH  - Aged
MH  - Antineoplastic Agents/*adverse effects/immunology/therapeutic use
MH  - Cohort Studies
MH  - Desensitization, Immunologic/*methods
MH  - Dose-Response Relationship, Drug
MH  - Drug Hypersensitivity/*immunology/prevention & control
MH  - Female
MH  - Humans
MH  - Immunoglobulin E/*immunology
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Organoplatinum Compounds/adverse effects/immunology/therapeutic use
MH  - Prospective Studies
MH  - Pyridines/adverse effects/immunology/therapeutic use
MH  - Sensitivity and Specificity
MH  - Skin Tests/methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - ImmunoCAP
OT  - chemotherapy
OT  - desensitization
OT  - drug allergy
OT  - oxaliplatin
EDAT- 2013/05/08 06:00
MHDA- 2013/11/07 06:00
CRDT- 2013/05/08 06:00
PHST- 2012/12/05 00:00 [accepted]
PHST- 2013/05/08 06:00 [entrez]
PHST- 2013/05/08 06:00 [pubmed]
PHST- 2013/11/07 06:00 [medline]
AID - 10.1111/all.12105 [doi]
PST - ppublish
SO  - Allergy. 2013 Jul;68(7):853-61. doi: 10.1111/all.12105. Epub 2013 May 6.