Desensitizing oxaliplatin-induced fever: a case report

R Madrigal-Burgaleta, M P Berges-Gimeno, D Angel-Pereira, C Guillen-Ponce, M L Sanz, E Alvarez-Cuesta
2013 Journal of investigational allergology & clinical immunology  
Symptoms of hypersensitivity reactions to oxaliplatin range from cutaneous reactions, such as ushing, pruritus, and urticaria to life-threatening respiratory and cardiovascular conditions, including bronchospasm, chest pain, and hypotension [1]. Oxaliplatin-induced fever may lead to discontinuation of treatment in some patients [2]; however, fever has been reported to be an idiosyncratic reaction caused by chemotherapy and, therefore, not amenable to rapid desensitization [3]. Desensitization
more » ... . Desensitization has been shown to be successful in small series of individuals diagnosed with oxaliplatin hypersensitivity, and patients were able to continue their treatment, which, otherwise, would have been discontinued [1,3]. We found no publications in which a desensitization protocol was used to prevent oxaliplatin-induced fever. We report the case of a 64-year-old man presenting with fever, shivering, general malaise, and headache as the manifestations of an adverse reaction to oxaliplatin-based chemotherapy administered to treat metastatic colorectal cancer. These manifestations were not observed during the rst infusions, but appeared 30 minutes after starting the 10th infusion. The symptoms recurred in the next 3 infusions despite the use of a slow infusion rate and intensi ed premedication with antipyretics, corticosteroids, and antihistamines. Treatment was suspended. After discontinuation of treatment with oxaliplatin, the patient tolerated all drugs involved in the reaction except for oxaliplatin. Given that the patient had undergone several ineffective lines of therapy, he was referred to our Desensitization Program in order to assess administration of oxaliplatin. In all the reactive administrations, blood and intravenous ❚ Manuscript
pmid:24459821 fatcat:3fs4xvlmejhlrlgt7qda4bdiam