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REVIEW: oxaliplatin allergy severity rating is importantDoubtof oxaliplatin from platinum allergic patients' pharmacists, yesterday I 7th oxaliplatin chemotherapy, I'm allergic, and flushed, flustered, chest tightness, nausea, vomiting, low blood pressure all of a sudden, scary, how do ah, no previous allergic ah, I can follow-up with oxaliplatin chemotherapy do? "
oxaliplatinonset mechanism of allergic after oxaliplatin and carboplatin cisplatin third generation platinum anticancer drugs in clinical often associated with 5-fluorouracil and leucovorin in combination to colon cancer, stomach cancer, etctreatmentCompared to a second-generation platinum, oxaliplatin nephrotoxicity than cisplatin mild myelosuppression lighter than carboplatinOxaliplatin adverse reactions mainly neurotoxicity, gastrointestinal tract, hematopoietic system toxicity and allergic reactionsmechanism of allergic reactions: allergic reaction mechanism is not clear, the mechanism Analysis of IgE-mediated allergy and type Ⅰ [1], i.e., oxaliplatin into the body may induce specific IgE antibodies when IgE when the antibody in contact with a certain amount of oxaliplatin and again, it can quickly produce hypersensitivityaddition, studies have shown that [2], oxaliplatin as a super antigen hapten commission cells major histocompatibility complex (MHC) different peptides in combination, thereby promoting T cell proliferation and release of cytokines cause allergic reactionsAccording to a study reported [3-4],oxaliplatin allergic reaction generally occurs in the first 5-6 cycles of chemotherapyThe median number of courses of oxaliplatin allergic reaction is the first 6 cycles (1-14 cycles), the median cumulative dose of 1200mg (400-1200mg)Allergic reactions occur within 5-360min after the start of infusion of oxaliplatin, the median time was 180minThe overall incidence of allergic reactions oxaliplatin 10.3% -24.2%grading the severity of a allergicNCI (v3.0) treatment of a severe allergic reaction Grading standards a mild to moderate allergic reaction (I-II, 78.8%)
: immediately stop oxaliplatin, by glucocorticoids and antihistamines symptomatic treatment, the allergy symptoms improvedContinue treatment oxaliplatin infusion time may be extended, if still allergic reactions, disabled oxaliplatin chemotherapya severe (Ⅲ-Ⅴ, 21.2%): immediately stop oxaliplatin, active rescueSubsequent stop oxaliplatin chemotherapyOverall, oxaliplatin allergy pathogenesis is very complex, the exact mechanism is unclearAll current clinical treatment measures can not absolutely prevent the occurrence of allergiesGeneral allergic reactions at different first, oxaliplatin allergy often occurs in the first 5-6 cycles of chemotherapy, the need for close monitoringPatients with an allergic reaction occurs, seek medical treatment in the description allergies, your doctor will evaluate the overall severity of allergic patients and clinical efficacy in patients with treatment, on balance it is necessary to consider whether the application again1References Jiayong Xu, Lijuan, Li Xing alkylene oxaliplatin and allergic desensitization Scheme 6 cases [J], Clinical Medicine, 2009,29 (6): 8-9
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Santini D, Tonini G, Vincenzi B, et alIdiosyncratic reaction after oxaliplatin infusion [J]Ann Oncol, 2001,12: 132-1333Cai Qiang, Xiu asked, Fangying Li, Gong strong allergic reaction to oxaliplatin uranium clinical data analysis [J], Journal of Shandong University (Medical Sciences), 201149 (12): 149-152 4 Yang Zhao, Anxin, to Xiao Juandeng Clinical features of allergic reactions oxaliplatin Chinese patients with colorectal cancer [J] Cancer, 2010, 29 (1): 102 -105 Editor: This article is a penicillin drug CFINS reproduced content, copyright owned by the original author, aimed at passing reproduced more information, do not represent the views of this platform Involving work content, copyright and other issues, please contact the website message, we will remove content for the first time Related Tags: a country, a oxaliplatin, a allergies, side effects 0 0