BACKGROUND: Chemotherapy is one of the main treatments for lung cancer, and in these patients, discontinuation of treatment due to uncontrollable hypersensitivity reactions (HSRs) is an important problem. AIM: To determine the frequency of HSRs during chemotherapy and to review current approaches. METHODS: We did a cross sectional study in patients undergoing chemotherapy for lung cancer in a reference chemotherapy unit from January 2012 to January 2013. Patients who developed immediate-HSRs or delayed-HSRs to chemotherapeutics and gave consent were included into study. The effectiveness of a standardised 12-step "rapid drug desensitisation" (RDD) procedure was investigated in patients with immediate-HSRs. RESULTS: In total, 1,099 cycles of chemotherapy were administered to 292 patients in 1 year. We observed ten HSRs, during ten cycles in ten patients (~3 % of the patients). Two HSRs were delayed-type, eight were immediate-type at grade 1-3. Of those with immediate-type HSR, five patients with grade 2-3, and additional two referred patients with grade 4 HSRs were successfully given their culprit drug in 35 cycles of chemotherapy with 12-step or modified 20-step RDD protocol. CONCLUSIONS: HSRs to chemotherapeutics are not so rare. Premedication alone does not prevent such reactions. The results of RDD treatment look promising for continuing treatment with the culprit chemotherapeutic agent.
BACKGROUND: Chemotherapy is one of the main treatments for lung cancer, and in these patients, discontinuation of treatment due to uncontrollable hypersensitivity reactions (HSRs) is an important problem. AIM: To determine the frequency of HSRs during chemotherapy and to review current approaches. METHODS: We did a cross sectional study in patients undergoing chemotherapy for lung cancer in a reference chemotherapy unit from January 2012 to January 2013. Patients who developed immediate-HSRs or delayed-HSRs to chemotherapeutics and gave consent were included into study. The effectiveness of a standardised 12-step "rapid drug desensitisation" (RDD) procedure was investigated in patients with immediate-HSRs. RESULTS: In total, 1,099 cycles of chemotherapy were administered to 292 patients in 1 year. We observed ten HSRs, during ten cycles in ten patients (~3 % of the patients). Two HSRs were delayed-type, eight were immediate-type at grade 1-3. Of those with immediate-type HSR, five patients with grade 2-3, and additional two referred patients with grade 4 HSRs were successfully given their culprit drug in 35 cycles of chemotherapy with 12-step or modified 20-step RDD protocol. CONCLUSIONS: HSRs to chemotherapeutics are not so rare. Premedication alone does not prevent such reactions. The results of RDD treatment look promising for continuing treatment with the culprit chemotherapeutic agent.
Authors: K M Zanotti; L A Rybicki; A W Kennedy; J L Belinson; K D Webster; B Kulp; G Peterson; M Markman Journal: J Clin Oncol Date: 2001-06-15 Impact factor: 44.544
Authors: Hugh A Sampson; Anne Muñoz-Furlong; Ronna L Campbell; N Franklin Adkinson; S Allan Bock; Amy Branum; Simon G A Brown; Carlos A Camargo; Rita Cydulka; Stephen J Galli; Jane Gidudu; Rebecca S Gruchalla; Allen D Harlor; David L Hepner; Lawrence M Lewis; Phillip L Lieberman; Dean D Metcalfe; Robert O'Connor; Antonella Muraro; Amanda Rudman; Cara Schmitt; Debra Scherrer; F Estelle Simons; Stephen Thomas; Joseph P Wood; Wyatt W Decker Journal: Ann Emerg Med Date: 2006-04 Impact factor: 5.721
Authors: Mariana C Castells; Nichole M Tennant; David E Sloane; F Ida Hsu; Nora A Barrett; David I Hong; Tanya M Laidlaw; Henry J Legere; Samridhi N Nallamshetty; Ross I Palis; Jayanti J Rao; Suzanne T Berlin; Susana M Campos; Ursula A Matulonis Journal: J Allergy Clin Immunol Date: 2008-05-27 Impact factor: 10.793
Authors: E A Eisenhauer; W W ten Bokkel Huinink; K D Swenerton; L Gianni; J Myles; M E van der Burg; I Kerr; J B Vermorken; K Buser; N Colombo Journal: J Clin Oncol Date: 1994-12 Impact factor: 44.544