Oxaliplatin
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Hypersensitivity reaction: case report A 25-year-old woman developed hypersensitivity reaction manifested as dyspnoea, giddiness, generalised uneasiness and sweating during treatment with oxaliplatin for metastatic colorectal cancer. The woman, who was diagnosed with ulcerative colitis, presented with bleeding per rectum, altered bowel habits and weight loss for duration of 6 months. On presentation, a sigmoid colonic mass was found extending up to the rectosigmoid junction. Staging revealed metastatic disease. Based on these findings, a diagnosis of metastatic colorectal cancer was made. Therefore, she underwent cytoreductive surgery and received chemotherapy with mitomycin [mitomycin C], doxorubicin, folinic acid [leucovorin] and fluorouracil [5-fluorouracil] uneventfully. Post-operative histopathology revealed pathological stage T4bN1bM1. Subsequently, she started receiving adjuvant chemotherapy with capecitabine and oxaliplatin infusion [Dacotin; dosage not stated] (CAPOX) with cycle interval of 21 days. She tolerated the first cycle of CAPOX well. Therefore, the second cycle was administered. However, she developed a grade 3 hypersensitivity reaction secondary to the oxaliplatin infusion. She complained of dyspnoea, giddiness, generalised uneasiness and sweating. The woman was treated with unspecified antihistamine and corticosteroid. During the third cycle of CAPOX, she again developed a similar hypersensitivity reaction to oxaliplatin. Therefore, oxaliplatin therapy was stopped. After the discontinuation of oxaliplatin therapy, treatment was planned with a modified oxaliplatin desensitisation protocol on an inpatient basis. Subsequently, she received the calculated dose of oxaliplatin (total dose 190mg) divided into five separate infusions of serially increasing concentrations of oxaliplatin. The entire infusion protocol lasted for 6h. At this time, she tolerated the infusions without any hypersensitivity or anaphylactic reactions. After successful desensitisation, she subsequently received her fourth and fifth cycle of oxaliplatin on an outpatient basis without any complications. At the time of the report, she has a good performance status, her disease is in partial remission, and she continues to be on follow‑up. Ghosh S, et al. A novel oxaliplatin desensitization protocol: Short, safe, and effective. Indian Journal of Medical and Paediatric Oncology 41: 287-288, No. 2, Apr 2020. 803497273 Available from: URL: http://doi.org/10.4103/ijmpo.ijmpo_99_19
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Reactions 22 Aug 2020 No. 1818
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