Hypersensitivity Reactions Associated with Platinum Antineoplastic Agents: A Systematic Review

Table 2

Types of hypersensitivity reactions, their characteristics, and how they are implicated in platinum agent hypersensitivity.

Type of hypersensitivity	Antigen	Mediated by	Mechanism	Involved in platinum hypersensitivity	Symptoms related
I	Soluble antigen	IgE	Mast cell and basophil degranulation	Carboplatin, Cisplatin, Oxaliplatin (most)	Early onset symptoms: itching, chest pain, rash, anaphylactic reactions
II	Cell- or matrix- associated antigen	IgG, IgM	Phagocyte and NK-cell activation	Oxaliplatin	Hemolysis, thrombocytopenia
III	Soluble antigen	IgG	Immune complexes, Phagocyte and NK-cell activation, complement fixation	Oxaliplatin	Chronic urticaria, joint pain, proteinuria
IV	Soluble or cell-associated antigen	T-cells (TH1, TH2, Cytotoxic T cells)	Macrophage and eosinophil activation, cytotoxicity	Carboplatin, Cisplatin	Delayed reactions, hours or even days after infusion