Carboplatin
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Anaphylaxis: 2 case reports In a case series, two women aged 57 year and 61 year, were described, who developed anaphylaxis during treatment with carboplatin for ovarian adenocarcinoma or breast and endometrial cancer [routes, dosages and durations of treatments to reactions onsets not stated]. The 57-year-old woman developed anaphylaxis during treatment with carboplatin for ovarian adenocarcinoma. The woman was diagnosed with ovarian adenocarcinoma and initially treated with carboplatin and paclitaxel without any complications. One year later, due to the development of a local recurrence of adenocarcinoma, she started receiving carboplatin and gemcitabine. During the cycle 2 of carboplatin (eighth exposure), she developed a generalised erythematous rash and palmar pruritus, which resolved after treatment with dexchlorpheniramine and methylprednisolone. During the next cycle (ninth exposure), she developed nausea, vomiting, palmar pruritus, generalised erythematous rash, and reported a sense of impending doom. Blood workup showed BP as 60/30mm Hg and HR as 40 bpm. Meanwhile, her reactions were treated with epinephrine [adrenaline], dexchlorpheniramine and methylprednisolone. Thereafter, she also experienced epigastric pain radiating to the back. An elevation in ST-segment in leads V1 to V6, troponin I level were noted with normal creatine kinase MB. After 24h, her symptoms resolved. Later, she was referred for an allergological workup and skin prick testing (SPT) and intradermal testing (IDT) with carboplatin was performed. The IDT test was found to be positive. Based on history, symptoms and allergy work-up results, a diagnosis of carboplatin-induced anaphylaxis was made. In view of positive IDT result and severity of the reaction, rapid drug desensitisation (RDD) with omalizumab was considered. Therefore, the scheduled RDD procedure with omalizumab was performed, and she tolerated 6 cycles with the same protocol without any complications. The 61-year-old woman developed anaphylaxis during treatment with carboplatin for breast and endometrial cancer: The woman was diagnosed with breast and endometrial cancer, and initially treated with radiotherapy and unspecified chemotherapy. Thereafter, due to the recurrence of cancer, she started receiving carboplatin and paclitaxel. During the third cycle (seventieth exposure to carboplatin), she developed nausea, blurred vision, general malaise, hypotension and severe bronchospasm, which resolved with unspecified treatment. Later, SPT and IDT with carboplatin were performed and the IDT test was found to be positive. Based on history, symptoms and allergy work-up results, a diagnosis of carboplatin-induced anaphylaxis was made. Thereafter, the RDD with omalizumab was considered and a scheduled RDD procedure with omalizumab was performed. However, she reacted in all cycles with skin reaction manifested as palmar pruritus and facial erythema to a generalised rash only once. Consequently, her anaphylaxis reaction resolved after treated with unspecified antihistamines and co
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