Immunoallergology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Avenida Professor Egas Moniz, 1649-035, Lisbon, Portugal,
Curr Allergy Asthma Rep. 2014 Aug;14(8):451. doi: 10.1007/s11882-014-0451-7.
Hypersensitivity reactions (HSRs) to platinum drugs and taxanes are increasing in cancer patients, and rapid drug desensitization has emerged as a safe and effective method to reintroduce these drugs in reactive patients. Optimal management of patients presenting HSRs to chemotherapy depends on the use of various diagnostic tools, which include measurement of mast cell/basophil mediator release following a HSR and skin testing. Serum tryptase should be measured in patients presenting chemotherapy HSRs, and its elevation would support mast cell/basophil activation. Skin testing to platinum drugs has a high sensitivity and specificity and is critical to guide the management of platinum-reactive patients. Taxane skin testing is also emerging as a useful diagnostic and risk stratification tool in the evaluation of patients with HSRs to taxanes. Platinum sIgE assays have been recently developed and can be helpful in combination with skin testing or as an alternative when skin testing is not available.
过敏反应（HSRs）在癌症患者中对铂类药物和紫杉烷类药物的发生率不断增加，快速药物脱敏已成为一种安全有效的方法，可重新引入这些药物在反应性患者。对化疗药物发生 HSRs 的患者的最佳管理取决于各种诊断工具的使用，其中包括测量 HSR 后肥大细胞/嗜碱性粒细胞介质的释放和皮肤试验。在出现化疗 HSRs 的患者中应测量血清类胰蛋白酶，其升高支持肥大细胞/嗜碱性粒细胞激活。铂类药物皮肤试验具有高灵敏度和特异性，对于指导铂类药物反应性患者的管理至关重要。紫杉烷类药物皮肤试验也作为一种有用的诊断和风险分层工具在评估 HSRs 患者中出现。最近开发了铂类药物 sIgE 检测，可与皮肤试验结合使用，或在皮肤试验不可用时作为替代方法。
