ACMJ
Anatolian Current Medical Journal

Anatolian Current Medical Journal (ACMJ) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Etoposide hypersensitivity reactions and outcomes of desensitizations in immediate-type hypersensitivity reactions
Abstract
Aims: This study aims to define characteristics of hypersensitivity reactions with etoposide, and outcomes of desensitizations in immediate-type hypersensitivity rections
Methods: This is a retrospective observational study of patients who had hypersensitivity reactions with etoposide from January 2019 to December 2023.
Results: A total of 39 patients with lung cancer were included in the study. Ten (25.6%) patients had known other drug allergies and three (7.7%) patients had previous chemotherapeutic hypersensitivity two with paclitaxel and one with docetaxel. Most of the initial hypersensitivities were in the first or second cycle (n=29, 74.4%). Ten (25.4%) patients had hypersensitivity reactions at the first application of etoposide. Thirty (76.9%) patients had immediate-type hypersensitivity reactions. There was no significant difference in terms of patient and initial hypersensitivity characteristics between patients who had immediate or non-immediate type hypersensitivity reactions. Of the 30 patients with immediate-type hypersensitivity reactions, initial reaction was mild in 16 (53.3%) and moderate in 14 (46.7%) patients. Most common symptoms were erythema in 29 (96.7%), dyspnea in 13 (43.3%), chest tightness in 8 (26.7%), discomfortness in 7 (23.3%), and hypertension in 6 (20%). Skin tests were negative in five patients who underwent skin testing. A total of 98 desensitization courses were performed in 27 patients and 3 (11.1%) patients had breakthrough reactions.
Conclusion: Most of the hypersensitivity reactions to etoposide are immediate-type and not severe. Desensitization is an effective and safe procedure to manage these reactions. Further research is needed to elucidate the mechanisms of hypersensitivity reactions.

Keywords : Etoposide, hypersensitivity, desensitization, reaction, immediate, chemotherapy

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1. Pagani M, Bavbek S, Alvarez-Cuesta E, et al. Hypersensitivityreactions to chemotherapy: an EAACI position paper. Allergy.2022;77(2):388-403.
2. Henwood JM, Brogden RN. Etoposide. A review of itspharmacodynamic and pharmacokinetic properties, andtherapeutic potential in combination chemotherapy of cancer.Drugs. 1990;39(3):438-490.
3. Martinez N, Miyasaki A, Roh L, Koole W, Fernandez KS. Apediatric desensitization protocol for etoposide. Am J Health SystPharm. 2020;77(4):277-281.
4. Wright TE, Shah MD, Rider NL, et al. A case series of pediatriconcology patients undergoing successful rapid etoposidedesensitization. Pediatr Allergy Immunol. 2019;30(5):579-582.
5. Cotteret C, Rousseau J, Zribi K, Schlatter J. Severe hypersensitivityreaction to etoposide phosphate: a case report. Clin Case Rep.2020;8(9):1821-1823.
6. Hoetelmans RM, Schornagel JH, ten Bokkel Huinink WW,Beijnen JH. Hypersensitivity reactions to etoposide. AnnPharmacother. 1996;30(4):367-371.
7. Hudson MM, Weinstein HJ, Donaldson SS, et al. Acutehypersensitivity reactions to etoposide in a VEPA regimen forHodgkin’s disease. J Clin Oncol. 1993;11(6):1080-1084.
8. Bernstein BJ, Troner MB. Successful rechallenge with etoposidephosphate after an acute hypersensitivity reaction to etoposide.Pharmacotherapy. 1999;19(8):989-991.
9. Siderov J, Prasad P, De Boer R, Desai J. Safe administrationof etoposide phosphate after hypersensitivity reaction tointravenous etoposide. Br J Cancer. 2002;86(1):12-13.
10. Lindsay H, Gaynon P. Anaphylactic reaction to etoposidephosphate. Pediatr Blood Cancer. 2012;59(4):765.
11. Ogle KM, Kennedy BJ. Hypersensitivity reactions to etoposide.A case report and review of the literature. Am J Clin Oncol.1988;11(6):663-665.
12. Vervloet D, Durham S. Adverse reactions to drugs. BMJ.1998;316(7143):1511-1514.
13. Zweizig S, Roman LD, Muderspach LI. Death from anaphylaxisto cisplatin: a case report. Gynecol Oncol. 1994;53(1):121-122.
14. Castells M, Sancho-Serra Mdel C, Simarro M. Hypersensitivityto antineoplastic agents: mechanisms and treatment with rapiddesensitization. Cancer Immunol Immunother. 2012;61(9):1575-1584.
15. Buhari GK, Kalkan IK, Ates H, et al. Platin desensitizationsin thoracic malignancies and risk factors for breakthroughreactions. Allergol Immunopathol (Madr). 2023;51(2):130-136.
16. Demoly P, Adkinson NF, Brockow K, et al. Internationalconsensus on drug allergy. Allergy. 2014;69(4):420-437.
17. Brown SG. Clinical features and severity grading of anaphylaxis.J Allergy Clin Immunol. 2004;114(2):371-376.
18. Castells MC, Tennant NM, Sloane DE, et al. Hypersensitivityreactions to chemotherapy: outcomes and safety of rapiddesensitization in 413 cases. J Allergy Clin Immunol.2008;122(3):574-580.
19. Stockton WM, Nguyen T, Zhang L, Dowling TC. Etoposide andetoposide phosphate hypersensitivity in children: incidence,risk factors, and prevention strategies. J Oncol Pharm Pract.2020;26(2):397-405.
20. Turgay Yagmur I, Guzelkucuk Z, Yarali N, et al. Evaluationof hypersensitivity reactions to cancer chemotherapeuticagents in pediatric patients. Ann Allergy Asthma Immunol.2020;124(4):350-366.
21. Picard M. Management of hypersensitivity reactions to taxanes.Immunol Allergy Clin North Am. 2017;37(4):679-693.
22. Friedland D, Gorman G, Treat J. Hypersensitivity reactions fromtaxol and etoposide. J Natl Cancer Inst. 1993;85(24):2036.
23. Leguay Z, Bourneau-Martin D, Pellier I, et al. Successful treatmentwith etoposide base after an acute hypersensitivity reaction toetoposide phosphate. Pediatr Blood Cancer. 2016;63(3):571.
24. Collier K, Schink C, Young AM, How K, Seckl M, Savage P.Successful treatment with etoposide phosphate in patientswith previous etoposide hypersensitivity. J Oncol Pharm Pract.2008;14(1):51-55.
25. Sambasivan K, Mahmoud S, Kokache A, Seckl M, Savage P.Hypersensitivity reactions to etoposide phosphate. J OncolPharm Pract. 2014;20(2):158-160.
26. Babaie D, Shamsian BS, Momtazmanesh N, et al. Rapiddesensitization for hypersensitivity reactions to chemotherapeuticdrugs; a case series. Iran J Pharm Res. 2019;18(2):1047-1051.
27. Pantin C, Letellez J, Calzas J, Mohedano E. [Indirect identificationof hypersensitivity reaction to etoposide mediated by polysorbate80]. Farm Hosp. 2018;42(1):27-28.
28. Kellie SJ, Crist WM, Pui CH, et al. Hypersensitivity reactionsto epipodophyllotoxins in children with acute lymphoblasticleukemia. Cancer. 1991;67(4):1070-1075.
29. Kulhas Celik I, Guvenir H, Buyuktiryaki B, Dibek Misirlioglu E,Ozyoruk D, Toyran M. Successful desensitization to etoposidein a preschool pediatric patient. J Investig Allergol Clin Immunol.2018;28(5):363-364.
30. Garcia Escallon S, Muniyappa PK, Subramanian S. Successfulrapid desensitization to intravenous etoposide using a 14-stepprotocol. J Allergy Clin Immunol Pract. 2015;3(4):627-628.
Article available in :
Volume 6, Issue 2, 2024
Page : 175-180
https://doi.org/10.38053/acmj.1430895
Article Information
Received : 02 Şub 2024
Accepted : 19 Şub 2024
Published : 08 Mar 2024
Corresponding Author :

Gözde Köycü Buhari: Atatürk Chest Disease and Chest Surgery Training and Research Hospital, Department of Allergy and Immunology, Ankara, Turkey

[email protected]
Citation : Köycü Buhari G, Nazik Bahçecioğlu S, Gültuna S, et al. Etoposide hypersensitivity reactions and outcomes of desensitizations in immediate-type hypersensitivity reactions. Anatolian Curr Med J. 2024;6(2):175-180.

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