Carboplatin
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Various toxicities: 5 case reports In an observational retrospective study of patients who underwent carboplatin desensitisation protocol from 2016 to 2018, five women aged 36–70 years were described, who developed hypersensitivity reactions in the form of anaphylaxis (flushing, chest pain and hypotension), nausea, abdominal pain, hypoxia, cold sweat, flushing, itching or shortness of breath during treatment with carboplatin for gynecologic cancers. Additionally, they developed other side effects comprising nausea, decreased WBC count, decreased neutrophil count, liver function impairment, anaemia or decreased platelet count during desensitisation protocol with carboplatin [durations of treatments to reactions onsets not stated; not all routes and outcomes stated]. Patient 1: A 55-year-old woman developed hypersensitivity reaction in the form of anaphylaxis (flushing, chest pain and hypotension) during treatment with carboplatin for ovarian cancer. Additionally, she developed hypersensitivity reactions in the form of flushing and palpitation during desensitisation protocol with carboplatin. The woman, who had FIGO stage IIIC poorly differentiated ovarian cancer, had received 25 courses of carboplatin. The total dose of carboplatin was 14815mL. During the therapy, she had developed hypersensitivity reactions in the form of grade 4 anaphylaxis (flushing, chest pain and hypotension). As a result, she underwent a four-step, 5h desensitisation protocol using carboplatin. Prior to the desensitisation protocol, she received pre-medications comprising dexamethasone, ranitidine and dexchlorpheniramine [d-chlorpheniramine-maleate]. The first infusion bag contained 1/1000 of the total dose diluted in glucose over 60 minutes; the bags used subsequently contained 1/100 and 1/10 of the total carboplatin dose. During infusion of 1/100 of the total dose diluted solution, she developed grade 2 hypersensitivity reaction in the form of flushing in both the hands. The symptom was limited; hence, the desensitisation protocol was continued with a careful observation. The last undiluted bag was administered over 120 minutes. The full dose of carboplatin was administered in 5 hours. During the protocol, she had also developed grade 2 hypersensitivity reaction in the form of palpitation. She received treatment with nitroglycerine, unspecified antihistamines and unspecified glucocorticoids. She recovered completely after the treatment. Her symptoms did not recur. However, the carboplatin desensitisation protocol was stopped. She then received topotecan [nogitecan] for ovarian cancer. Patient 2: A 36-year-old woman developed hypersensitivity reactions in the form of nausea, abdominal pain, hypoxia and cold sweat during treatment with carboplatin for endometrial cancer. Additionally, she developed other side effects comprising nausea, decreased WBC count, decreased neutrophil count and liver function impairment during desensitisation protocol with carboplatin. The woman, who had FIGO stage IVB endometrial cancer, had received 9 courses o
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