Thursday, 15 October 2015: 11:15 - 11:30
Room R2 ABC (Floor 3) (Coex Convention Center)
Hye Jung Park, MD
,
Severance Hospital Regional Pharmacovigilance Centre, Seoul, South Korea
Jae-Hyun Lee, MD, PhD
,
Severance Hospital Regional Pharmacovigilance Centre, Seoul, South Korea
Sungryeol KIM, MD
,
Severance Hospital Regional Pharmacovigilance Centre, Seoul, South Korea
Kyung Hee Park, MD
,
Severance Hospital Regional Pharmacovigilance Centre, Seoul, South Korea
Choong-Kun Lee
,
Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
Beodeul Kang
,
Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
Seung-Hoon Beom
,
Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
Sang Joon Shin
,
Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
Minku Jung
,
Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
Jung-Won Park, MD, PhD
,
Severance Hospital Regional Pharmacovigilance Centre, Seoul, South Korea
Chein-Soo Hong, MD, PhD
,
Dept. of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
Background: The prevalence of immediate hypersensitivity reaction (IHSR) to platinum-based chemotherapy has been rising, with the increase of chemotherapy usage. Although there is a proven ultimate solution, desensitization protocol, it has not yet applied in many institutes because of impracticalities such as cost, procedure duration and lack of trained manpower. Prediction of the success of a desensitization protocol will help reduce unnecessary workload.
Objective: We aimed to determine the clinical characteristics and currently adopted measures against oxaliplatin IHSR and to predict the success of our newly developed practical desensitization protocol.
Methods: We retrospectively reviewed 2,640 cases of oxaliplatin IHSR in 271 oxaliplatin users who admitted to Severance hospital. We prospectively used our new desensitization protocol 31 times in 12 patients with hypersensitivity to platinum-based chemotherapy. The new desensitization protocol was conducted with escalating of infusion rate regularly regardless of the concentration of bags, in order from 60 mL/h to 120 mL/h and 240 mL/h about every 15 minutes.
Results: In 271 patients who administered oxaliplatin, 45 patients (16.6%) experienced oxaliplatin IHSR. In 39 patients, who experienced IHSR but need to keep oxaliplatin, 6 patients (15.4%) stopped due to the IHSR and 33 patients (84.6%) kept the regimen regardless of the anticipated risk. Any significant risk factor for the IHSR was not found. The new desensitization protocol was successfully completed in 12 patients (100%). However, among these 12 patients, the protocol was ineffective in 3 patients having fever without urticaria and a negative response in a skin prick test.
Conclusions: Many patients who experience oxaliplatin IHSR are required to stop the effective regimen or maintain the regimen without desensitization with the anticipated risk of IHSR. Our new practical desensitization protocol might be applied easily and conveniently in real clinical practice. Fever without urticaria and a negative response in a skin prick test indicate that this desensitization protocol might be ineffective.
