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一种新的化疗药物快速脱敏方案。

A new rapid desensitization protocol for chemotherapy agents.

机构信息

Department of Allergology and Clinical Immunology, Clinica Universidad de Navarra, Pamplona, Spain.

出版信息

J Investig Allergol Clin Immunol. 2011;21(2):108-12.

Abstract

BACKGROUND

Desensitization has been used for some decades to treat patients with the allergenic drug when an alternative drug with similar efficacy and safety is not available. We present the results from a series of oncology patients desensitized at our hospital during the last 2 years.

OBJECTIVE

To assess the efficacy of a new desensitization protocol in patients allergic to chemotherapy drugs.

METHODS

We performed an observational retrospective study of 11 women (6 breast cancer and 5 ovarian cancer) who underwent our desensitization protocol. Four patients had immediate reactions to carboplatin, 3 to docetaxel, 3 to paclitaxel, and 1 to both docetaxel and paclitaxel. Premedication was administered in all cases. A 5-step protocol based on 5 different dilutions of the drugs was used.

RESULTS

We performed 39 desensitization procedures: 14 to carboplatin, 3 to oxaliplatin, 16 to docetaxel, and 6 to paclitaxel. Eight patients tolerated the full dose in 36 procedures. One patient suffered an anaphylactic reaction to carboplatin that reverted with treatment. One patient had dyspnea after a paclitaxel cycle. One patient experienced dyspnea due to chronic pulmonary thromboembolism related to her disease.

CONCLUSION

Desensitization is a useful procedure in patients who are allergic to their chemotherapy agents.

摘要

背景

脱敏治疗已在临床上应用数十年,用于治疗在缺乏疗效和安全性相当的替代药物时出现过敏的患者。我们报告了过去 2 年在我院接受脱敏治疗的一系列肿瘤患者的结果。

目的

评估一种新的化疗药物过敏患者脱敏方案的疗效。

方法

我们对 11 名接受我们的脱敏方案的女性(6 名乳腺癌,5 名卵巢癌)进行了一项观察性回顾性研究。4 名患者对卡铂、3 名对多西他赛、3 名对紫杉醇、1 名对多西他赛和紫杉醇均有即刻反应。所有病例均给予了预处理。采用基于药物 5 种不同稀释度的 5 步方案。

结果

我们共进行了 39 次脱敏治疗:14 次卡铂、3 次奥沙利铂、16 次多西他赛和 6 次紫杉醇。8 名患者在 36 次治疗中有 8 名患者耐受了全剂量。1 名患者在卡铂脱敏治疗中发生过敏反应,经治疗后缓解。1 名患者在紫杉醇周期后出现呼吸困难。1 名患者因与疾病相关的慢性肺血栓栓塞症而出现呼吸困难。

结论

在对化疗药物过敏的患者中,脱敏治疗是一种有用的方法。

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