A protocol for risk stratification of patients with carboplatin-induced hypersensitivity reactions.
J Allergy Clin Immunol
; 129(2): 443-7, 2012 Feb.
Article
em En
| MEDLINE
| ID: mdl-22099941
ABSTRACT
BACKGROUND:
Management of patients with carboplatin-induced hypersensitivity reactions (HSR) has been complicated by high false-negative rates of carboplatin skin test (ST) results. These patients might be at risk for future carboplatin-induced HSRs. In this article we identify a strategy to improve risk stratification of patients with a history of carboplatin-induced HSRs by using a protocol that includes repeat skin testing and drug desensitization.OBJECTIVE:
We sought to identify a management strategy for patients with a history of carboplatin-induced HSRs with negative carboplatin ST results.METHODS:
From 2008-2010, patients with carboplatin-induced HSR underwent risk stratification per a protocol using 3 repeat STs with intervening drug desensitizations.RESULTS:
Of the 44 patients with carboplatin-induced HSRs, 39 completed the protocol. Patients were classified as having positive ST results (n = 16), having negative ST results (n = 11), or ST converters when the ST result converted to positive after an initial negative result (n = 12). ST converters are more likely to have HSRs during subsequent desensitizations than patients with negative ST results (56.1% vs 4.5%, P < .001). ST converters had a significantly longer time interval between their initial HSR and initial ST evaluation compared with either patients with true-negative ST results (22.1 vs 6.0 months, P = .03) or patients with positive ST results (22.1 vs 1.8 months, P = .001).CONCLUSION:
Our experience suggests that repeat STs are necessary for risk stratification in patients with a remote clinical history of HSR and an initial negative ST result because there is a significant rate of conversion to a positive ST result. ST converters have an increased risk of HSRs during subsequent carboplatin treatment.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carboplatina
/
Hipersensibilidade a Drogas
Tipo de estudo:
Etiology_studies
/
Guideline
/
Prognostic_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Allergy Clin Immunol
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Estados Unidos