Yamaguchi Shinichiro, Yahata Hideaki, Okugawa Kaoru, Kodama Keisuke, Yagi Hiroshi, Yasunaga Masafumi, Ohgami Tatsuhiro, Onoyama Ichiro, Asanoma Kazuo, Kato Kiyoko
Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Obstet Gynaecol Res. 2021 Apr;47(4):1544-1548. doi: 10.1111/jog.14680. Epub 2021 Jan 27.
PEGylated liposomal doxorubicin (PLD) is a therapeutic agent for gynecological malignancy. Hypersensitivity reaction (HSR) is a major adverse effect that usually disappears after halting administration of PLD. Premedication is usually not necessary before administration of PLD to prevent HSR. Here, we evaluated the frequency of HSR during administration of PLD following premedication in Japanese women.
We performed PLD administration in 78 patients (386 cycles) between 2013 and 2018. Granisetron hydrochloride and dexamethasone sodium phosphate were administered 30 min before PLD administration. Then, PLD (40 or 30 mg/m combined usage with carboplatin) was administered. We retrospectively reviewed the medical records of 78 patients and examined the frequency of HSR.
Seven of 78 (9%) patients showed HSR by PLD administration following premedication. One patient showed cardiopulmonary arrest in 13 min after PLD administration (grade 4). The other six patients showed grade 2 HSR. All patients developed HSR in the first course. The incidence of HSR was significantly higher in patients with allergic history than in patients without allergic history (p = 0.0151).
Clinicians should be aware of the potential for HSR in patients administered PLD, particularly those with allergic history and those receiving the first cycle of PLD, even following premedication.
聚乙二醇化脂质体阿霉素(PLD)是一种用于妇科恶性肿瘤的治疗药物。过敏反应(HSR)是一种主要的不良反应,通常在停止使用PLD后消失。在使用PLD前通常无需进行预处理以预防HSR。在此,我们评估了日本女性在预处理后使用PLD期间HSR的发生频率。
我们在2013年至2018年期间对78例患者(386个周期)进行了PLD给药。在PLD给药前30分钟给予盐酸格拉司琼和磷酸地塞米松钠。然后,给予PLD(40或30mg/m²联合卡铂使用)。我们回顾性分析了78例患者的病历并检查了HSR的发生频率。
78例患者中有7例(9%)在预处理后使用PLD时出现HSR。1例患者在PLD给药后13分钟出现心肺骤停(4级)。其他6例患者出现2级HSR。所有患者均在第一个疗程中出现HSR。有过敏史的患者HSR发生率显著高于无过敏史的患者(p = 0.0151)。
临床医生应意识到接受PLD治疗的患者发生HSR的可能性,尤其是有过敏史的患者和接受PLD第一个周期治疗的患者,即使在预处理后也是如此。