Desensibilización rápida en pacientes con reacción moderada a severa de hipersensibilidad a oxaliplatino

Jorge Luis Soriano García, Mayté Lima Pérez, Masiel González Meisozo, Ana Josefa Artiles Morales, Luis Alberto Fuentes Crespo, Yolanda Hernández García, Yorinko Díaz Chacón, Paula Bárbara Díaz Díaz

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Resumen

Introducción: La desensibilización rápida a medicamentos induce una tolerancia temporal a los citostáticos que provocan reacciones de hipersensibilidad.

Objetivo: Evaluar las características de pacientes que presentaron hipersensibilidad moderada y severa a oxaliplatino, y los resultados obtenidos con el uso de un protocolo de desensibilización rápido.

Métodos: Se realizó un estudio observacional y retrospectivo, de 20 pacientes con cáncer colorrectal que desarrollaron una reacción de hipersensibilidad a oxaliplatino entre 2016 y 2018, en el hospital de día onco-hematológico del “Hospital Ameijeiras”. Se clasificaron según su intensidad, y se analizaron variables demográficas, características clínicas, y síntomas presentados. Se utilizó un protocolo en doce etapas basado en tres diluciones del fármaco. Se administró premedicación en todos los casos. Se realizó estadística descriptiva, y para la asociación entre variables, se utilizó la prueba estadística Chi-cuadrado.

Resultados: La mediana de edad fue 60 años (37-77), y predominaron los hombres; antecedentes de alergia; las reacciones de hipersensibilidad durante la infusión, de intensidad moderada, y en escenario adyuvante. Fueron más frecuentes los síntomas cutáneos, gastrointestinales, y respiratorios. Con la aplicación del protocolo se completó la quimioterapia planificada a los 20 pacientes (90 ciclos adicionales). El 91,1 % de las desensibilizaciones no presentaron reacción. Solo se presentaron ocho desensibilizaciones con reacciones leves de tipo cutáneas.

Conclusiones: La aplicación de un protocolo de desensibilización rápida a oxaliplatino demostró ser eficaz y seguro en el escenario ambulatorio, con un manejo multidisciplinario. 

Palabras clave: hipersensibilidad; oxaliplatino; desensibilización.

Referencias

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