Journal of Asthma and Allergy (Jul 2023)
Interdisciplinary Healthcare Team Experience of Carboplatin and Oxaliplatin Desensitizations in a Tertiary Referral University Hospital
Abstract
Ceyda Tunakan Dalgic,1 Asuman Camyar,1 Nihal Mete Gokmen,1 Sukriye Miray Kilincer Bozgul,2 Mehmet Zuhuri Arun,3 Zehra Tuba Karaman,2 Elif Ertuna3 1Department of Internal Medicine, Division of Allergy and Immunology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey; 2Department of Internal Medicine, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey; 3Department of Clinical Pharmacy, Faculty of Pharmacy, Ege University, Bornova, Izmir, TurkeyCorrespondence: Elif Ertuna, Department of Clinical Pharmacy, Faculty of Pharmacy, Ege University, Bornova, Izmir, 35040, Turkey, Tel +90 532 672 5988, Fax +90 232 388 5258, Email [email protected]: Repeated exposure to platinum compounds increases the risk of immunoglobulin E-mediated immediate hypersensitivity reactions (HSR). To date, many different desensitization protocols with varying success rates have been reported. The presented study is aimed at disseminating the real-world experience of an interdisciplinary healthcare team focusing on platin desensitization.Patients and Methods: This is a cross-sectional, retrospective study of 7 female patients with carboplatin- or oxaliplatin-induced HSRs. After a discussion with the oncologist and the patient, desensitization protocols were performed by a team consisting of an allergy and immunology specialist, a clinical pharmacist, and a nurse. Clinical data were extracted from the patients’ medical records, and HSRs were reviewed and classified by an allergist according to severity and type.Results: Twenty-five desensitization protocols were carried out for patients with carboplatin- or oxaliplatin-induced HSRs (N=4 and N=3, respectively; age range: 54– 66). Two of the patients did not experience any HSR during a total of 8 desensitization cycles. The other patients had grade 1– 3 HSRs on 15 cycles, which were successfully managed by oxygen and/or pharmacological interventions and infusions were resumed at a lower rate after stabilization of the patient. Compared to baseline, serum tryptase levels were elevated during HSRs (4.77± 0.21 vs 9.50± 1.71, P=0.028).Conclusion: All the patients were able to finish the treatment protocol and receive full chemotherapeutic doses. Interdisciplinary teams may facilitate the preparation and administration of platinum-based chemotherapeutics and increase the success rates of desensitization protocols for platin-based chemotherapy, where the concentration and application of drugs differ from standard procedure.Keywords: platinum compounds, platin hypersensitivity, rapid drug desensitization, immediate reactions, chemotherapy, clinical pharmacist
