Department of Pharmacy, Mie University Hospital, Faculty of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Cancer Chemother Pharmacol. 2011 Feb;67(2):415-9. doi: 10.1007/s00280-010-1338-5. Epub 2010 May 5.
The rate of hypersensitivity reactions in patients receiving carboplatin (CBDCA) has been reported to increase after multiple doses of the agent. However, risk factors for these onsets have not been well described. In this study, we investigated the contribution of the reported risk factors to the onset of CBDCA-related delayed hypersensitivity reactions.
We reviewed the records of gynecologic cancer patients receiving CBDCA of more than 7 cycles in Mie University Hospital from March 2006 to July 2009. The patients were divided into two groups on the basis of whether hypersensitivity reactions developed (13 patients) or not (43 patients). Thereafter, the potential influences of the patients' characteristics on the development of CBDCA-related delayed hypersensitivity reactions were explored using logistic regression analyses.
The median CBDCA-free interval (10 months) in patients with hypersensitivity reactions was significantly higher than that (3 months) in patients without hypersensitivity reactions. Logistic regression analyses revealed a CBDCA-free interval >13 months (odds ratio 22.2, 95% confidence interval 2.57-192, p < 0.01) and a maximum dose of CBDCA > 650 mg (odds ratio 9.52, 95% confidence interval 1.04-93.9; p < 0.05) were significantly correlated with the incidence of CBDCA-related delayed hypersensitivity reactions.
Careful attention should be paid to the onset of delayed hypersensitivity reactions for recurrent gynecologic cancer patients receiving CBDCA > 650 mg after an interval of more than 13 months from the previous CBDCA administration.
据报道,接受卡铂(CBDCA)治疗的患者在多次用药后,过敏反应的发生率会增加。然而,这些发作的危险因素尚未得到很好的描述。在这项研究中,我们研究了报告的危险因素对 CBDCA 相关迟发性过敏反应发作的贡献。
我们回顾了 2006 年 3 月至 2009 年 7 月期间在 Mie 大学医院接受 CBDCA 治疗超过 7 个周期的妇科癌症患者的记录。根据是否发生过敏反应(13 例)将患者分为两组。然后,使用逻辑回归分析探讨患者特征对 CBDCA 相关迟发性过敏反应发展的潜在影响。
过敏反应患者的 CBDCA 无药间隔(10 个月)明显长于无过敏反应患者(3 个月)。逻辑回归分析显示 CBDCA 无药间隔>13 个月(优势比 22.2,95%置信区间 2.57-192,p<0.01)和 CBDCA 最大剂量>650mg(优势比 9.52,95%置信区间 1.04-93.9;p<0.05)与 CBDCA 相关迟发性过敏反应的发生率显著相关。
对于接受 CBDCA>650mg 治疗的复发性妇科癌症患者,在之前 CBDCA 给药后间隔超过 13 个月时,应密切注意迟发性过敏反应的发生。