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Prophylactic 3-hour graduated infusion schedule minimizes risk of carboplatin hypersensitivity reactions - A prospective study

Koul, Anjila LU ; Forsland, Eva L. and Bjurberg, Maria LU (2017) In Gynecologic Oncology
Abstract

Objective: Aim of this study was observation of hypersensitivity reaction (HSR) frequency by using a 3-hour graduated infusion protocol with appropriate premedication as a prophylactic measure in patients with gynecological cancer receiving carboplatin retreatment in second line or above. None of the patients had experienced HSRs to platinum previously. Method: All the patients in this study received premedication with corticosteroids and anti-histamines followed by carboplatin as 3-hour graduated infusion. Carboplatin was administered either as monotherapy or in combination with other chemotherapeutic agents. Results: Ninety-nine patients with ovarian (n = 71), fallopian tube (n = 9), peritoneal (n = 9) and other gynecological cancers... (More)

Objective: Aim of this study was observation of hypersensitivity reaction (HSR) frequency by using a 3-hour graduated infusion protocol with appropriate premedication as a prophylactic measure in patients with gynecological cancer receiving carboplatin retreatment in second line or above. None of the patients had experienced HSRs to platinum previously. Method: All the patients in this study received premedication with corticosteroids and anti-histamines followed by carboplatin as 3-hour graduated infusion. Carboplatin was administered either as monotherapy or in combination with other chemotherapeutic agents. Results: Ninety-nine patients with ovarian (n = 71), fallopian tube (n = 9), peritoneal (n = 9) and other gynecological cancers (5 uterine cancer, 5 abdominal cancer of gynecological origin) were retreated by a total of 611. cycles of carboplatin administered as monotherapy (210. cycles) or combination regime (401. cycles). HSRs were recorded in only 11. cycles (1.8%) in a total of 11 patients. While 8 of these patients had grade 1or 2 reactions (8.1%), only 3 patients had grade 3 reactions (3%). After pause in the infusion and complete resolution of HSR symptoms, an attempt of retreatment using this infusion protocol with extra premedication was successful in 6 of these patients without any reoccurrence of HSRs. Conclusion: In this prospective study, we report that prophylactic 3-hour graduated infusion rate with appropriate premedication is associated with low frequency of HSRs in gynecological cancer patients requiring carboplatin retreatment in second line or above.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Carboplatin, Hypersensitivity reactions, Ovarian cancer
in
Gynecologic Oncology
publisher
Academic Press
external identifiers
  • scopus:85036563675
ISSN
0090-8258
DOI
10.1016/j.ygyno.2017.11.032
language
English
LU publication?
yes
id
5a14fd45-0c17-454c-93b7-f8ca98eb0666
date added to LUP
2018-01-10 14:41:02
date last changed
2018-01-11 03:00:03
@article{5a14fd45-0c17-454c-93b7-f8ca98eb0666,
  abstract     = {<p>Objective: Aim of this study was observation of hypersensitivity reaction (HSR) frequency by using a 3-hour graduated infusion protocol with appropriate premedication as a prophylactic measure in patients with gynecological cancer receiving carboplatin retreatment in second line or above. None of the patients had experienced HSRs to platinum previously. Method: All the patients in this study received premedication with corticosteroids and anti-histamines followed by carboplatin as 3-hour graduated infusion. Carboplatin was administered either as monotherapy or in combination with other chemotherapeutic agents. Results: Ninety-nine patients with ovarian (n = 71), fallopian tube (n = 9), peritoneal (n = 9) and other gynecological cancers (5 uterine cancer, 5 abdominal cancer of gynecological origin) were retreated by a total of 611. cycles of carboplatin administered as monotherapy (210. cycles) or combination regime (401. cycles). HSRs were recorded in only 11. cycles (1.8%) in a total of 11 patients. While 8 of these patients had grade 1or 2 reactions (8.1%), only 3 patients had grade 3 reactions (3%). After pause in the infusion and complete resolution of HSR symptoms, an attempt of retreatment using this infusion protocol with extra premedication was successful in 6 of these patients without any reoccurrence of HSRs. Conclusion: In this prospective study, we report that prophylactic 3-hour graduated infusion rate with appropriate premedication is associated with low frequency of HSRs in gynecological cancer patients requiring carboplatin retreatment in second line or above.</p>},
  author       = {Koul, Anjila and Forsland, Eva L. and Bjurberg, Maria},
  issn         = {0090-8258},
  keyword      = {Carboplatin,Hypersensitivity reactions,Ovarian cancer},
  language     = {eng},
  publisher    = {Academic Press},
  series       = {Gynecologic Oncology},
  title        = {Prophylactic 3-hour graduated infusion schedule minimizes risk of carboplatin hypersensitivity reactions - A prospective study},
  url          = {http://dx.doi.org/10.1016/j.ygyno.2017.11.032},
  year         = {2017},
}