Investigation of allergic reactions to platinum salts

Revue des Maladies Respiratoires. 2006 Nov;23(5 Pt 1):458-62. [Link]

Touraine F, Sainte Laudy J, Boumediene A, Ndikumwenayo F, Decroisette C, Melloni B, Vergnenegre A, Bonnaud F.

Service de Pathologie Respiratoire, CHU de Limoges, Limoges, France.


Introduction: We report two cases occurring in 2004 of patients being treated for pleural mesothelioma with a combination of cisplatin or carboplatin and pemetrexed. Investigation by skin tests and flow cytometry confirmed the clinical diagnosis in both cases.

Case reports: Case 1: a man of 62 developed, after 12 courses of cisplatin-pemetrexed, an anaphylactic reaction 5 minutes after the infusion of cisplatin. Treatment was withdrawn permanently. Case 2: a man of 66 developed, after 7 courses of cisplatin-pemetrexed, an anaphylactic reaction within the first minute of the infusion of cisplatin. Subsequently, in March 2004, he received pemetrexed alone without any problems. In August 2004 he was prescribed carboplatin-pemetrexed. Within 5 minutes he developed urticaria, pruritus and abdominal pain. He was treated later with pemetrexed alone with no problems.

Conclusion: Hypersensitivity to platinum salts usually occurs after several courses of treatment. Skin tests and flow cytometry are a simple, concordant, and reliable way of confirming the diagnosis.