Hypersensitivity reactions in ovarian cancer patients receiving paclitaxel

Objective: The aim of this study was to describe a rapid retreatment strate gy in patients with paclitaxel hypersensitivity reactions. Methods: A retrospective review of all patients receiving standard S-hour i nfusion paclitaxel-based chemotherapy after proper premedication at the Dep artment of Gynecologic Oncology, University of Bari between 1995 and 1998, was performed. All patients who developed hypersensitivity reactions to pac litaxel were identified and their treatment course and outcome were reviewe d. A review of the literature on this subject is also presented. Results: Eighty-six women were treated with 461 cycles of paclitaxel-based chemotherapy at our Unit. Twelve patients (14%) developed hypersensitivity reactions. All had received standard premedication consisting of corticoste roids and hystamine blockers. Hypersensitivity reactions consisted of isola ted face flushes (3 patients), dyspnea and chest tightness (4 patients) or bronchospasm (5 patients). Eleven patients were rechallenged with the origi nal paclitaxel solution starting at a slower rate after a second premedicat ion with a double dosage of steroids. None of these patients had reactions in subsequent courses. Only one patient (the first of this series treated i n February 1995), was retreated 5 days later under strict monitoring in int ensive care unit. Conclusions: Retreatment with the original paclitaxel solution is safe in a lmost all patients with hypersensitivity reactions, The drug should be admi nistered within the next 24 hours with a new premedication protocol.