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Presentation and Diagnosis of Hypersensitivity to Platinum Drugs

  • Joana CaiadoEmail author
  • Mariana Castells
Anaphylaxis and Drug Allergy (DA Khan and M Castells, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Anaphylaxis and Drug Allergy

Abstract

Hypersensitivity reactions (HSRs) to platinum drugs are increasing due to their extensive use in a wide variety of malignancies and the repeated exposures in patients with increased life expectancy. Understanding the incidence of HSR to platinum drugs and associated risk factors can help with the diagnosis and may provide protection against severe HSRs. A thorough clinical history with identification of the typical and atypical symptoms, the relationship with the platin administration, and the number of previous exposures are the key to the diagnosis. An elevated serum tryptase at the time of the HSR indicates that IgE and/or mast cells/basophils were involved in the HSR. Skin testing to platinum drugs is a highly sensitive and specific diagnostic tool, which helps provide risk stratification and management recommendations. Platinum specific IgE measurement and basophil activation test (BAT) are emerging as new diagnostic tools and in combination with skin testing can help support the diagnosis and the cross-reactivity between the three most commonly used platinum drugs, namely carboplatin, cisplatin, and oxaliplatin.

Keywords

Chemotherapy Platinum drugs Carboplatin Cisplatin Oxaliplatin Hypersensitivity Allergy Diagnosis Skin test IgE Specific IgE Basophil activation test 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

D. Joana Caiado declares a grant from Fundação Luso-Americana para o Desenvolvimento (FLAD.) Mariana Castells reports personal fees from Merck and Sanofi, personal fees from BWH, grants from NIH Desensitization, personal fees from UpToDate, and other from AAAAIBOD.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Immunoallergology DepartmentHospital de Santa Maria, Centro Hospitalar Lisboa NorteLisbonPortugal
  2. 2.Division of Rheumatology, Immunology and Allergy, Department of Medicine, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA

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