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Annals of Oncology Advance Access published online on November 9, 2005
Annals of Oncology, doi:10.1093/annonc/mdj042
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© 2005 European Society for Medical Oncology
Received August 2, 2005
Revised September 11, 2005
Accepted September 12, 2005

original article

Hypersensitivity reactions to oxaliplatin: experience in a single institute

S. W. K. Siu 1*, R. T. T. Chan 1, and G. K. H. Au 1

1 Department of Clinical Oncology, Queen Mary Hospital, Pokfulam, Hong Kong

* To whom correspondence should be addressed.
S. W. K. Siu, E-mail: h9715590{at}graduate.hku.hk


  Abstract

Background: A rising incidence of hypersensitivity reactions to oxaliplatin has been observed as a result of increasing clinical use. Epidemiological and clinical features of these reactions are reviewed.

Patients and methods: Records of patients treated with a modified FOLFOX regimen from March 1999 to March 2004 were reviewed.

Results: One hundred and eighty patients were identified. Twenty-seven patients (15%) have been labelled as allergic to oxaliplatin, the proportion being higher among those receiving oxaliplatin in palliative second-line or above settings (19.6%) than in adjuvant or palliative first-line settings (10.2%). Some 2.2% of them developed grade 3-4 reactions. The reactions occurred after a mean (± SD) of 8.5 (± 4.2) cycles (range 1-18). Among the 14 patients re-exposed to oxaliplatin, four (28.6%) developed hypersensitivity reaction, in two of whom (14.3%) reactions were grade 3-4 in severity.

Conclusions: The risk of developing hypersensitivity reactions in patients receiving oxaliplatin should not be underestimated. The risk of developing potentially life-threatening hypersensitivity reactions should be explained to patients in the context of the potential benefits of such therapy. Patients receiving oxaliplatin infusion should be closely monitored. Once a patient develops hypersensitivity reaction to oxaliplatin, re-exposure should only be considered if the reaction is mild and there has been documented clinical benefit from previous doses of this agent.

Keywords: chemotherapy; hypersensitivity; oxaliplatin.
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