Otani Iris M, Wong Johnson, Banerji Aleena
Department of Medicine, Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, UCSF Medical Center, 400 Parnassus Avenue, Fifth Floor, San Francisco, CA 94143, USA.
Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Immunol Allergy Clin North Am. 2017 Nov;37(4):663-677. doi: 10.1016/j.iac.2017.06.003. Epub 2017 Aug 19.
Hypersensitivity reactions to platinum agents are common. For carboplatin and cisplatin, the first hypersensitivity reaction typically occurs around the second and third re-exposure during the second line of therapy (eighth and ninth courses overall). For oxaliplatin, the first hypersensitivity reaction can occur throughout the treatment course. Skin testing helps risk stratify patients to appropriate desensitization protocols and assess risk for breakthrough HSRs during desensitization. A risk-stratification protocol using 3 serial skin tests and desensitization protocols enables patients with platinum agent hypersensitivity to receive first-line chemotherapy treatment safely.
对铂类药物的超敏反应很常见。对于卡铂和顺铂,首次超敏反应通常发生在二线治疗的第二次和第三次再次暴露时(总体上是第八和第九疗程)。对于奥沙利铂,首次超敏反应可在整个治疗过程中发生。皮肤试验有助于对患者进行风险分层,以采用适当的脱敏方案,并评估脱敏过程中发生突破性超敏反应的风险。一种使用3次连续皮肤试验的风险分层方案和脱敏方案,能使对铂类药物过敏的患者安全地接受一线化疗。