Background: The incidence of chemotherapy-induced hypersensitivity reactions has increased gradually. This study aimed to describe clinical manifestations of hypersensitivity reactions to chemotherapy and the outcomes of management using desensitization protocol in patients with gynecologic cancers.
Methods: We conducted a retrospective study of patients with hypersensitivity reactions to chemotherapy drugs in gynecologic cancer between January 01, 2019 and July 31, 2021. (IRB number: 2021-1607)/ The severity of hypersensitivity reaction to chemotherapy was graded according to Brown’s classification and desensitization protocol by Castells, et al was performed.
Results: Among the 3147 patients, ninety-one patients experienced hypersensitivity reaction to chemotherapy. The mean age of the patients was 56.05 years and the proportion of underlying malignancy was ovarian cancer (81.3%), followed by cervical cancer (9.9%), and endometrial cancer (8.8%). The desensitized drugs were carboplatin, cisplatin, paclitaxel, docetaxel, bevacizumab, bleomycin, and ifosfamide. The most common allergic reactions was a cutaneous symptom (65.9%), followed by cardiovascular (60.4%), respiratory (41.8%), gastrointestinal (41.8%), neuromuscular (15.4%), and other system (12.1%). Seventy-five patients (82.5%) have experienced moderate to severe hypersensitivity reactions and 80 patients (87.9%) have successfully completed their planned cycles by 12 or 16-step protocol, whereas 11 patients (12.1%) have decided to stop consecutive chemotherapy due to failure of desensitization. There was no significant difference of clinical characteristics and outcome except death between two groups. These results demonstrate that desensitization protocol was safe and effective in highly sensitized patients.
Conclusions: In our study, we present the clinical characteristics of chemotherapy-induced hypersensitivity reactions and show that desensitization protocol was a best alternative strategy to maintain optimal chemotherapy in gynecologic cancer patients.