Hypersensitivity reactions to oxaliplatin: a case report and the success of a continuous infusional desensitization schedule

Anticancer Drugs. 2004 Jul;15(6):605-7. doi: 10.1097/01.cad.0000132235.38297.7c.

Abstract

Oxaliplatin is a third-generation platinum analog that is used mainly to treat advanced colorectal cancer. The reported incidence of hypersensitivity reactions to oxaliplatin, especially after multiple cycles of therapy, is less than 1%. We report a patient with metastatic colon cancer who developed a hypersensitivity reaction to oxaliplatin during the sixth cycle of combination chemotherapy with oxaliplatin, high-dose 5-fluorouracil and leucovorin. The same reaction occurred again after re-exposure to oxaliplatin 2 weeks later even with prophylactic administration of steroids and H1 antihistamines. After failing third-line treatment with oral tegafur-uracil, we desensitized the patient by using a fixed-rate 24-h continuous infusion of dilute oxaliplatin (0.15 mg/ml), in addition to steroids and H1 antihistamines. He had no hypersensitivity reaction during or after that infusion or when the same concentration was infused in the same way 2 weeks later. Because his condition subsequently deteriorated and the cancer progressed, no further oxaliplatin was given. Our experience does demonstrate, however, that a fixed-rate 24-h continuous infusion of oxaliplatin in a low concentration may prevent a hypersensitivity reaction in a previously sensitized patient.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / diagnosis
  • Colonic Neoplasms / drug therapy
  • Desensitization, Immunologic / methods*
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use
  • Diphenhydramine / administration & dosage
  • Diphenhydramine / therapeutic use
  • Drug Administration Schedule
  • Drug Hypersensitivity / etiology*
  • Fluorouracil / therapeutic use
  • Humans
  • Infusions, Intravenous
  • Leucovorin / therapeutic use
  • Liver Neoplasms / complications
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / drug therapy
  • Male
  • Neoplasm Metastasis / diagnosis
  • Neoplasm Metastasis / drug therapy
  • Organoplatinum Compounds / administration & dosage
  • Organoplatinum Compounds / adverse effects*
  • Organoplatinum Compounds / therapeutic use
  • Oxaliplatin
  • Rectal Neoplasms / complications
  • Rectal Neoplasms / diagnosis
  • Rectal Neoplasms / drug therapy
  • Taiwan
  • Time Factors

Substances

  • Organoplatinum Compounds
  • Oxaliplatin
  • Dexamethasone
  • Diphenhydramine
  • Leucovorin
  • Fluorouracil