A clinical classification system for grading platinum hypersensitivity reactions.

Autor: Vetter MH; Division of Gynecologic Oncology, Department of Obstetrics/Gynecology, The Ohio State University College of Medicine, Columbus, OH 43210, United States of America., Castaneda A; Division of Gynecologic Oncology, Department of Obstetrics/Gynecology, The Ohio State University College of Medicine, Columbus, OH 43210, United States of America., Khan A; Department of Pharmacy, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, United States of America., O'Malley DM; Division of Gynecologic Oncology, Department of Obstetrics/Gynecology, The Ohio State University College of Medicine, Columbus, OH 43210, United States of America. Electronic address: omalley.46@osu.edu.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2020 Dec; Vol. 159 (3), pp. 794-798. Date of Electronic Publication: 2020 Sep 18.
DOI: 10.1016/j.ygyno.2020.09.009
Abstrakt: Objectives: Current grading systems for platinum hypersensitivities (pHSR) rely on subjective features rather than objective clinical signs leading to inconsistencies in grading. To standardize classification of pHSR, a clinical grading system was developed at our institution. We report the clinical outcomes our classification system and evaluate its correlation with the classification systems currently published and used in practice.
Methods: This was a retrospective review of patients with pHSR from 2011 to 2017. Demographics, chemotherapeutic histories (CT), and details of their initial HSR were collected. Mild reactions were defined as local skin manifestations only. Moderate-low reactions included widespread skin, respiratory or GI findings. Moderate-standard reactions were defined as transient cardiovascular compromise (CVC), hypoxia or neurologic changes whereas sustained changes (>10 min) were used to define severe reaction. Fischer Exact Tests (p < .05) and binary logistic regression analyses were performed. Spearman correlation were used to assess relationships between our grading system and the NCCN and CTCAEv4.0 criteria.
Results: 87 patients were identified with most having ovarian cancer (n = 55, 63.2%), receiving carboplatin (n = 62, 71.3%), and on second-line CT (n = 34, 42.5%). Chest pain was associated with transient CVC (OR 10.0, 95% CI 1.148-87.133) while nausea/vomiting (OR 8.420, 95% CI 1.263-55.275) was associated with transient hypoxia albeit less closely than transient hypotension (OR 17.010, 95% CI 2.026-142.825). Only presyncope/syncope remained associated with sustained CVC (OR 38.0, 95% CI 2.815-512.912) on logistic regression. The classification system was most strongly correlated with the NCCN grading system (ρ 0.761, p < .001).
Conclusions: This classification system offers an objective means of grading pHSR severity and correlates with currently-used grading systems.
Competing Interests: Declaration of Competing Interest Dr. O'Malley reports personal fees and other from AstraZeneca, personal fees and other from Clovis, personal fees and other from Tesaro, personal fees and other from Immunogen, personal fees from Ambry, personal fees and other from Janssen/J&J, personal fees and other from Abbvie, personal fees and other from Regeneron, personal fees and other from Amgen, personal fees from Novocure, personal fees and other from Genentech/Roche, other from VentiRx, other from Array Biopharma, other from EMD Serono, other from Ergomed, other from Ajinomoto Inc., other from Ludwig Cancer Research, other from Stemcentrx, Inc., other from CERULEAN PHARMA, personal fees and other from GOG Foundation, other from Bristol-Myers Squibb Co, other from Serono Inc., other from TRACON Pharmaceuticals, other from Yale University, other from New Mexico Cancer Care Alliance, other from INC Research, Inc., other from inVentiv Health Clinical, other from Iovance Biotherapeutics, Inc., other from PRA Intl, personal fees from Myriad Genetics, personal fees and other from Eisai, personal fees and other from Agenus, personal fees and other from GSK, personal fees from Tarveda, personal fees and other from Merck, outside the submitted work. The other authors have no disclosures.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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