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Desensitization to Platinums: Our Experience with 153 Desensitizations
Saturday, March 5, 2016: 2:45 PM
Room 515A (Convention Center)
Meaghan R. Misiasz, MD, , ,

Rationale:

Many patients with gynecological malignancies require platinum based chemotherapy for treatment. Frequently, patients develop hypersensitivity reactions to these agents necessitating  their administration via a desensitization protocol.  This study presents our experience utilizing a 12-step, 3-bag desensitization protocol.  

Methods:

We performed a retrospective chart review  of patients with gynecological malignancies undergoing desensitizations to cisplatin and carboplatin from 1/1/2010 to 3/31/2015.  Data was collected regarding the original reaction and each desensitization.  Reaction severity was graded.

Results:

A total of 153 infusions were given via a desensitization protocol in 33 patients. Of note, 82 patients were identified with gynecological malignancies and a platinum allergy;  of these 33 (40%) were desensitized.  Eighteen patients (55%) had reactions during at least one desensitization with 38 total reactions (25% of all desensitizations). Eight patients reacted during initial desensitization and ten reacted during subsequent infusions. Seven patients had more severe reactions during desensitization than their original reaction. Most reactions (84%) occurred during infusion of the final concentration. Reactions were managed with medications and infusion rate adjustments. Infusion protocol rate adjustments were made in 28% of desensitizations. Desensitization was discontinued in four patients, two were later successfully desensitized. Preadmission treatment with antihistamines and/or glucocorticoids was not associated with a significantly lower occurrence of reactions. 

Conclusions:

Our experience with desensitizations to platinums indicates the risk of reaction to these medications during desensitization remains high even after the patient has tolerated an initial desensitization and the patient’s initial reaction does not predict the severity of subsequent reactions