Successful desensitization with chemotherapeutic drugs: a Tertiary Care Center Experience

¹Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University School of Medicine, Ankara, Turkey
²Department of Allergy and Clinical Immunology, Ankara City Hospital, Ankara, Turkey

Summary
Introduction. Hypersensitivity reactions to chemotherapeutic drugs are increasing all over the world, and desensitization to them has become the standard treatment approach. This study aimed to evaluate the characteristics of chemotherapeutic drug hypersensitivity reactions and the outcome of desensitization procedures. Methods. Between January 2017 and 2019, patients who have been desensitized to chemotherapeutic drugs were included retrospectively. Data were obtained from the medical records of the patients. Results.  A total of 35 patients were evaluated; of whom 24 (68.5%) were female and 11 were male (31.5%). The mean age was 54.54 ± 13.39 (min-max: 41-69) years. Colorectal cancer was the most common malignancy (n:14, 40%). Desensitization was performed with oxaliplatin in 17 (48.5%), carboplatin in nine (25.7%), paclitaxel in four (11.4%), cisplatin in two (5.7%), irinotecan in two (5.7%), rituximab in two (5.7%), and docetaxel in one (2.8%) patients. Thirty four (97.1%) were successfully desensitized without any reactions. Anaphylaxis occurred during desensitization with rituximab and the procedure could not be completed. The reactions occurred during the first administration of the chemotherapeutic agent in five (14.2%) patients. Skin tests were performed on 26 (74.2%) patients. Skin prick and intradermal tests were positive in 7 (26.9%) and 12 (46.1%) patients, respectively. Conclusions. Desensitization is an effective and safe treatment approach for chemotherapeutic drug hypersensitivity and can be performed safely by observing general precautions to anaphylaxis.