Outpatient rapid 4-step desensitization for gynecologic oncology patients with mild to low-risk, moderate hypersensitivity reactions to carboplatin/cisplatin
| Autor: | David E. Cohn, Quan Li, Ritu Salani, Allyson Waller, David M. O'Malley, Floor J. Backes, Jeffrey M. Fowler, Larry J. Copeland |
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| Rok vydání: | 2014 |
| Předmět: |
Time Factors
Genital Neoplasms Female medicine.medical_treatment Antineoplastic Agents Gynecologic oncology Risk Assessment Severity of Illness Index Carboplatin Drug Hypersensitivity chemistry.chemical_compound Carboplatin/cisplatin Ambulatory Care Clinical endpoint Humans Medicine Retrospective Studies Desensitization (medicine) Cisplatin Retrospective review business.industry Obstetrics and Gynecology Oncology chemistry Desensitization Immunologic Anesthesia Female business medicine.drug |
| Zdroj: | Gynecologic Oncology. 135:90-94 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2014.07.104 |
| Popis: | Objective The primary objective of this study is to assess the efficacy and safety of an outpatient, 4-step, one-solution desensitization protocol in gynecologic oncology patients with history of mild to low-risk, moderate hypersensitivity reactions (HSRs) to platinums (carboplatin and cisplatin). Methods This was a single institutional retrospective review. Gynecologic oncology patients with a documented history of mild or low-risk, moderate immediate HSRs to carboplatin/cisplatin and continued treatment with 4-step, one-solution desensitization protocols in the outpatient infusion center were included. Patients with delayed HSRs or immediate high-risk, moderate or severe HSRs were excluded. The primary end point was the rate of successful administrations of each course of platinums. Results From January 2011 to June 2013, eighteen eligible patients were evaluated for outpatient 4-step, one-solution desensitization. Thirteen patients had a history of HSRs to carboplatin and 5 with HSRs to cisplatin. All of 18 patients successfully completed 94 (98.9%) of 95 desensitization courses in the outpatient infusion center. Eight of 8 (100%) patients with initial mild HSRs completed 29/29 (100%) desensitization courses, and 9 of 10 (90%) of patients with initial moderate HSRs completed 65/66 (94%) desensitization courses. In total, 65/95 (68%) desensitizations resulted in no breakthrough reactions, and mild, moderate and severe breakthrough reactions were seen in 19%, 12% and 1% desensitizations, respectively. No patients were hospitalized during desensitization. Conclusions The outpatient rapid, 4-step, one-solution desensitization protocol was effective and appeared safe among gynecologic oncology patients who experienced mild to low-risk, moderate HSRs to carboplatin/cisplatin. |
| Databáze: | OpenAIRE |
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