Clinical Features of Hypersensitivity Reactions to Cisplatin and Carboplatin

Objective : To characterize the clinical features of platinum compounds (cisplatin plus carboplatin) associated hypersensitivity reactions. Methods : Medical records of 102 patients with gynecologic malignancy who received chemotherapy based on platinum at Center for Uterine Cancer from Jun. 2001 to Nov. 2002 were analyzed. Platinum hypersensitivity reaction was classified as acute and delayed reaction according to the time of onset, also mild and severe reaction according to the severity of symptoms and signs. Results : Among the 102 patients treated with platinum compounds during this period, 20 (20%) developed hypersensitivity reaction. The median number of platinum courses for the first episode was 7 (range 4-9) and it concentrated at 7, 8, 9th cycles. Fourteen patients developed acute reaction and six patients experienced delayed reaction. Ten patients experienced severe symptoms including dyspnea. Acute reaction developed from a few minutes to 30 minutes after the initiation of the platinum infusion. Delayed reaction developed after discharge of patients with mild intensity. Conclusion : Platinum hypersensitivity reactions develop in patients who have been extensively pre- treated with these agents. As platinum compounds are increasingly used as neoadjuvant, initial, second-line chemotherapy of ovarian cancer and concurrent chemoradiation, palliative setting of cervical cancer, it can be anticipated that hypersensitivity reactions to these drugs will happen more frequently, at the same time it might be a important issue for clinicians engaged in chemotherapy.