1 - Serviço de Imunoalergologia, Centro Hospitalar Universitário de Lisboa Central
- EAACI Hybrid Congress 2022
BACKGROUND. Hypersensitivity reactions (HRs) to chemotherapy agents may lead to the discontinuation of first-line treatments. Drug desensitization is useful in cases of HRs without a proper alternative. We aim to characterize the patients submitted to desensitization procedures in our Department.
METHODS. We conducted a retrospective analysis of the desensitization procedures to chemotherapy agents performed at our Allergy and Clinical Immunology Department from a tertiary hospital in Lisbon, Portugal, from January 2019 to December 2021. All adult patients who underwent a desensitization procedure to a chemotherapy drug were included. Data regarding the culprit agent, type of reaction leading to desensitization, and safety of desensitization procedures were analysed.
RESULTS. A total of 89 desensitizations to chemotherapy agents were performed in 14 patients, with a median (IQR) age of 54.5 (49.8-63.5) years, 79% (n= 11) female. The most frequent neoplasms were colorectal (n= 4; 29%), ovarian (n=4; 29%), and breast cancers (n=2; 14%). The desensitization procedures were performed in eight patients (57%) with HRs to platins (oxaliplatin, n=5; carboplatin, n=3;), in five patients (36%) with HR to taxanes (docetaxel, n=3; paclitaxel, n=2), and in one patient (7%) with HR to epipodophyllotoxins (etoposide). The median (IQR) treatment cycle of occurrence of HR was 7.0 (6.0-8.8) cycles to platins and 1 (1-2) cycles to taxanes. The most common type of reaction at presentation was type 1 HR (n=9; 64%). HRs were classified according to Brown’s classification as grade 1 (n=8; 57%), grade 2 (n=5; 36%), and grade 3 (n=1; 7%). Skin tests were performed in 10 patients (71%): five with HR to platins, four (80%) of them positive; four with HR to taxanes, all negative; and one patient with HR to etoposide, also negative. All patients received premedication based on the type and severity of the reactions. Breakthrough reactions occurred in six patients (43%), most common in those with HR to platins (n=5/8; 63%). All the breakthrough reactions were classified as grade 1. All patients were successfully desensitized.
CONCLUSION. Drug desensitization procedures to chemotherapy agents were safe, allowing all patients with HRs to these drugs to receive a first-line treatment recommended for their disease.
Palavras Chave: dessensibilização, fármacos, hipersensibilidade