Padidėjusio jautrumo reakcijos, susijusios su platinos priešvėžiniais vaistais. Pilotinis tyrimas

Abstract

Introduction. Platinum antineoplastic agents (PAA) (cisplatin, carboplatin, and oxaliplatin) have been approved for the first-line chemotherapy of numerous malignancies, such as ovarian, bladder, colorectal, and lung cancer. Their widespread use has resulted in a significant increase in drug-induced hypersensitivity reactions. Hypersensitivity usually appears after multiple infusions of PAA, suggesting type I hypersensitivity reactions. Aim. To evaluate the type and prevalence of hypersensitivity to PA A among the patients, studied due to suspected PAA allergy in the Department of Immunology and Allergology of HLUHS Kaunas Clinics. Methods. A retrospective study of 20 patients (19 women and 1 man) (mean age: 62.31 ± 8.28 years) who were consulted for suspected PAA allergy in the Department of Immunology and Allergology, HLUHS Kaunas Clinics during 2021–2023. All subjects underwent skin provocation tests with PPP: skin prick tests with carboplatin (10 mg/ml) were performed for 50% of subjects, 40% with oxaliplatin (1 mg/ml), and 25% with cisplatin (1 mg/ml); whereas, intradermal skin tests were performed in 50% of subjects: 25% with carboplatin (0.1 mg/ml), 30% with oxaliplatin (0.5 mg/ml) and 15% with cisplatin (0.11 mg/ml). During diagnostic tests, immediate hypersensitivity reactions were evaluated after 20 minutes and delayed-type reactions – after 24 hours. Results. 65% of studied subjects confirmed hypersensitivity to PAA: carboplatin (n = 8), oxaliplatin (n = 5), and cisplatin (n = 4). All of them have immediate hypersensitivity reactions and 70% delayed-type reactions. 40% of subjects with PAA had ovarian cancer. The most common complaints were hives (n = 7), facial flushing (n = 5), itching (n = 5), shortness of breath (n = 5), and nausea (n = 5). Conclusions. Evaluation of patients with suspected allergy to platinum antineoplastic agents showed that 65% of them are sensitised (most commonly to carboplatin and oxaliplatin) and have an immediate type of hypersensitivity with prevalent clinical sign–hives.