Review Article

Hypersensitivity Reactions Associated with Platinum Antineoplastic Agents: A Systematic Review

Table 6

Published desensitization protocols for oxaliplatin hypersensitivity. We observe that almost all protocols deliver the platinum agent at escalating concentrations and administer premedication.

PatientsPremedication-Dose-RouteStepsDurationSuccess rate

Syrigou et al. (2009) [58]3NoneFrom 1 : 100000 to 1 : 1 in 13 steps8 hours100%

Castells et al. (2008) [53]1Diphenhydramine or hydroxyzine 25 mg po or iv, famotidine 20 mg iv or ranitidine 50 mg iv, lorazepam (0.5–1 mg po or iv as needed for anxiety)From 1 : 100 to 1 : 1 in 12 steps5.8 hours100%

Nozawa et al. (2008) [59]1Famotidine 20 mg iv QD, Dexamethasone 20 mg iv QD, diphenhydramine 50 mg po QID, domperidone 10 mg po QID, hydrocortisone 100 mg iv QD, granistron 3 mg iv QDFrom 1 : 10000 to 1 : 1 in 5 steps8 hours100%

Wrzesinski et al. (2007) [60]1Famotidine 20 mg iv BID, Dexamethasone 20 mg iv QD, diphenhydramine 50 mg iv QD, magnesium sulfate 1 g iv BID, calcium gluconate 1 g iv BID, ondasetron 8 mg iv BIDFrom 1 : 10000 to 1 : 1 in 5 steps6 hours100%

Edmondson et al. (2007) [61]1NoneFrom 1 : 10000 to 1 : 2 in 12 steps205 minutes100%

Herrero et al. (2006)[62]5NoneFrom 0.003 to 0.75 mg/min in several steps5-6 hours100%

Mis et al. (2005) [63]1Dexamethasone 20 mg iv, prednisolone 20 mg po QID, diphenhydramine 50 mg iv, cimetidine 300 mg iv, magnesium sulfate 1 g iv, calcium gluconate 1 g iv, ondasetron 8 mg ivFrom 1 : 10000 to 1 : 1 in 5 steps8  hours100%

Lim et al. (2004) [64]1Diphenhydramine 50 mg po QID and 30 mg iv QD, metoclopramide 9 mg iv QDContinuous fixed rate24 hours100%

Gammon et al. (2004) [65]1Dexamethasone iv, hydrocortisone 100 mg iv, diphenhydramine ivFrom 1 : 10000 to 1 : 1 in 5 steps8 hours100%

Schüll et al. (2001) [66]1Dexamethasone iv (high dose), antihistamine iv, ondasetron 8 mg ivContinuous fixed rate48 hours100%

BID: twice a day, iv: intravenously, po: by mouth, QD: once a day, QID: four times a day.