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Anaphylactic and anaphylactoid reactions to chemotherapy: outcomes and safety of rapid intravenous and intraperitoneal desensitizations in 413 cases.

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Sub-category:
Ovarian Cancer

Category:
Gynecologic Cancer

Meeting:
2008 ASCO Annual Meeting

Session Type and Session Title:
Poster Discussion, Gynecologic Cancer

Abstract No:
5526

Citation:
J Clin Oncol 26: 2008 (May 20 suppl; abstr 5526)

Author(s):
M. C. Castells, N. M. Tennant, D. E. Sloane, F. I. Hsu, S. T. Berlin, S. M. Campos, U. A. Matulonis

Abstract:

Background: Hypersensitivity reactions to chemotherapeutic drugs, including monoclonal antibodies, often require that the provoking medication be discontinued, thus raising a dilemma for the caregiver: further use could precipitate a severe, even fatal, allergic reaction upon re-exposure, but alternative drugs may be poorly tolerated or much less effective compared to the preferred agent. To address this difficulty, we have developed a standardized rapid desensitization protocol for achieving temporary tolerization to drug allergens. In this study, we evaluate the safety and efficacy of this protocol. Methods: Ninety-eight patients who developed hypersensitivity reactions in response to treatment with carboplatin, cisplatin, oxaliplatin, paclitaxel, pegylated doxorubicin, adriamycin, or rituximab received rapid desensitization to these agents. A standardized 12-step protocol was used, with treatment applied intravenously or intraperitoneally. Initial desensitizations occurred in the Medical Intensive Care Unit, while most subsequent infusions took place in an outpatient setting. Safety and efficacy of the protocol were assessed by review of treatment records. Results: Of the 413 desensitizations performed, 94% induced mild or no reactions. No life-threatening HSRs or deaths occurred during the procedure, and all patients received their full target dose. Most reactions occurred during the first desensitization. Reactions were most commonly reported at the last step of the protocol. Desensitization infusions via the intravenous and intraperitoneal routes were equally effective. Conclusions: Our standardized 12-step protocol for rapid drug desensitization is safe and effective and should be the standard of care in treating patients who develop hypersensitivity reactions to chemotherapeutic drugs, including monoclonal antibodies.


Abstract Disclosures

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy and are designated with a caret symbol (^) here and in the print version.


  Associated Presentation(s):

    

1. Anaphylactic and anaphylactoid reactions to chemotherapy: outcomes and safety of rapid intravenous and intraperitoneal desensitizations in 413 cases.

Meeting: 2008 ASCO Annual Meeting
Presenter: Mariana C Castells, MD, PhD
Session: Gynecologic Cancer (Poster Discussion)


  Other Abstracts in this Sub-Category:

    

1. Exploratory phase II efficacy study of MORAb-003, a monoclonal antibody against folate receptor alpha, in platinum-sensitive ovarian cancer in first relapse.

Meeting: 2008 ASCO Annual Meeting   Abstract No: 5500   First Author: D. K. Armstrong
Category: Gynecologic Cancer - Ovarian Cancer

    

2. Cediranib (AZD2171) is an active agent in recurrent epithelial ovarian cancer.

Meeting: 2008 ASCO Annual Meeting   Abstract No: 5501   First Author: U. A. Matulonis
Category: Gynecologic Cancer - Ovarian Cancer

    

3. A phase III trial of cisplatin plus topotecan followed by paclitaxel plus carboplatin versus standard carboplatin plus paclitaxel as first-line chemotherapy in women with newly diagnosed advanced epithelial ovarian cancer (EOC) (OV.16). A Gynecologic Cancer Intergroup Study of the NCIC CTG, EORTC GCG, and GEICO.

Meeting: 2008 ASCO Annual Meeting   Abstract No: LBA5505   First Author: P. J. Hoskins
Category: Gynecologic Cancer - Ovarian Cancer

    

More...


  Abstracts by M. C. Castells :

    

1. Anaphylactic and anaphylactoid reactions to chemotherapy: outcomes and safety of rapid intravenous and intraperitoneal desensitizations in 413 cases.

Meeting: 2008 ASCO Annual Meeting   Abstract No: 5526   First Author: M. C. Castells
Category: Gynecologic Cancer - Ovarian Cancer

    

2. Rapid inpatient and outpatient desensitization for carboplatin or paclitaxel hypersensitivity: a protocol effective in patients with gynecologic malignancies

Meeting: 2005 ASCO Annual Meeting   Abstract No: 5090   First Author: C. Lee
Category: Gynecologic Cancer

    

More...


  Presentations by M. C. Castells :

    

1. Anaphylactic and anaphylactoid reactions to chemotherapy: outcomes and safety of rapid intravenous and intraperitoneal desensitizations in 413 cases.

Meeting: 2008 ASCO Annual Meeting
Presenter: Mariana C Castells, MD, PhD
Session: Gynecologic Cancer (Poster Discussion)

    

More...


  Educational Book Manuscripts by M. C. Castells :

    

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