Oxaliplatin-induced severe anaphylactic reactions in metastatic colorectal cancer： Case series analysis

• Published in: World journal of gastroenterology : WJG Vol. 18; no. 38; pp. 5427 - 5433
• Main Authors: Wang, Jui-Ho, King, Tai-Ming, Chang, Min-Chi, Hsu, Chao-Wen
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 14.10.2012
• Subjects: Adult; Aged; Anaphylaxis - chemically induced; Anaphylaxis - diagnosis; Anaphylaxis - mortality; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Brief; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - pathology; Female; Fluorouracil - adverse effects; Fluorouracil - therapeutic use; Humans; Leucovorin - adverse effects; Leucovorin - therapeutic use; Male; Middle Aged; Neoplasm Metastasis; Organoplatinum Compounds - adverse effects; Organoplatinum Compounds - therapeutic use; PubMed; Retrospective Studies; SAR; Severity of Illness Index; 奥沙利铂; 病例; 结直肠癌; 转移性; 过敏反应; 过敏性反应; Oxaliplatin; Metastasis; Anaphylactic; Colorectal cancer
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i38.5427

AIM： To investigate oxaliplatin-induced severe anaphylactic reactions （SAR） in metastatic colorectal cancer in a retrospective case series analysis and to conduct a systemic literature review. METHODS： During a 6-year period from 2006 to 2011 at Kaohsiung Veterans General Hospital, a total of 412 patients exposed to oxaliplatin-related chemotherapy were retrospectively reviewed. Relevant Englishlanguage studies regarding life-threatening SAR following oxaliplatin were also reviewed in MEDLINE and PubMed search. RESULTS： Eight patients （1.9%, 8 of 412 cases） were identified. Seven patients were successful resuscitated without any sequelae and one patient expired. We changed the chemotherapy regimen in five patients and rechallenged oxaliplatin use in patient 3. Twenty-three relevant English-language studies with 66 patients were reported. Patients received a median of 10 cycles of oxaliplatin （range, 2 to 29）. Most common symptoms were respiratory distress （60%）, fever （55%）, and hypotension （54%）. Three fatal events were reported （4.5%）. Eleven patients （16%） of the 66 cases were rechallenged by oxaliplatin. CONCLUSION： SAR must be considered in patients receiving oxaliplatin-related chemotherapy, especially in heavily pretreated patients. Further studies on the mechanism, predictors, preventive methods and management of oxaliplatin-related SAR are recommended.