ArticleThe World Allergy Organization journal2022
Rapid drug desensitization with platin-based chemotherapy: Analysis of risk factors for breakthrough reactions.
Article in The World Allergy Organization journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Rapid Drug Desensitization to Platinum-based Chemotherapy Agents: A Single-center Experience.Thoracic research and practice · 2026Article
- Breakthrough reactions in pediatric chemotherapeutic desensitization: Outcomes and associated risk factors.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Observational
- Maintaining oxaliplatin therapy after hypersensitivity reactions: real-world experience with a desensitisation protocol.Clinical and experimental medicine · 2026Observational
- Comparison of rapid and same-day desensitization protocols in hypersensitivity reactions to platinum and taxanes: a retrospective cohort study.Frontiers in allergy · 2026Article
- Comparison of three-bag and single-bag protocols in rapid drug desensitization with chemotherapeutic and biological agents.The World Allergy Organization journal · 2025Article
- Successful desensitization to etoposide in a patient after cardiac arrest.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2025Article
- The impact of repeated drug desensitisation on quality of life in drug hypersensitivity.Clinical and translational allergy · 2025Article
- Oxaliplatin desensitization for ovarianGynecologic oncology reports · 2024Article
- Hypersensitivity Reactions to Taxanes: A Multicenter Study for Outcomes and Safety of Rapid Drug Desensitization.Allergy, asthma & immunology research · 2024Article
- A survey of carboplatin desensitization therapy in Japan: A multicenter retrospective study.Cancer medicine · 2024Observational
- The increasing role of the allergist in the management of infusion reactions at the Oncology Infusion Center.Frontiers in allergy · 2024Article
- Comparison of two diagnostic criteria in the diagnosis of anaphylaxis in a tertiary adult allergy clinic.The World Allergy Organization journal · 2023Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAll platin-based chemotherapeutics can cause hypersensitivity reactions (HSRs). With rapid drug desensitization (RDD), few patients experience breakthrough reactions (BTR) during desensitization. However, data about risk factors for BTRs during RDD in patients with HSRs to platins are limited. We first aimed to describe characteristics of our platin-reactive population and to validate the Brigham and Women's Hospital's (BWH's) RDD protocol in our population along with their outcomes with RDD. Our second aim was to identify the risk factors for BTRs.
methodThis was a retrospective chart review (2013-2020) of patients with symptoms of immediate HSRs to platins. Initial HSRs were classified as grade 1, 2, or 3 based on their severity. Skin prick tests (SPT)/intradermal tests (IDT) were performed with implicated platins. A 12-step protocol was used during RDD.
resultsThe study comprised 65 women and seven men (mean age 57.78 ± 8.73 years). Initial HSRs to carboplatin, cisplatin, and oxaliplatin occurred in 38, 13, and 21 patients, respectively. All patients reacted at the fifth (median) recurrent infusions (min:1, max:20). The median values for carboplatin, cisplatin, and oxaliplatin were 6 (1-20), 3 (1-15), and 3 (1-11), respectively. Most initial HSRs were grade 2 (n = 40, 55.6%) and 3 (n = 27, 37.5%); only 6.9% (n = 5) were grade 1. Patients with grade 1, 2, and 3 initial HSRs had positive platin skin test results at rates of 80%, 74%, and 88%, respectively.A total of 232 RDDs were performed in 72 patients and 98.7% of these desensitizations were completed. BTRs occurred in 56 (24.1%) (grade 1 n = 14, 25%; grade 2 n = 32, 57%; grade 3 n = 10, 18%) of these desensitizations. Breakthrough reactions were more severe in patients with positive SPTs or 1:100 or 1:10 dilutions of IDT (p = 0.014). BTR was not observed during RDD in any of the patients with positive 1:1 dilutions of IDT. Positivity on prick or 1:100 or 1:10 IDT increased the risk of BTR 5.058 times. There was no significant association between the risk of BTRs and age, drug cycle, sex, comorbidities, or atopy.
conclusionIn our experience, 98.7% of 232 RDDs to platins were completed successfully, showing that RDD was safe and effective. Drug skin test positivity is a potential marker for identifying high-risk patients who will have BTRs during RDDs to platins.
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