University of Lynchburg DMSc Doctoral Project Assignment Repository
Specialty
Hematology/Oncology
Abstract
ABSTRACT
Background: Moderate hypersensitivity reactions (HSR) defined as grade 2 reactions with mucocutaneous symptoms may lead to discontinuation of oxaliplatin. Oxaliplatin is an important component of perioperative therapy for gastrointestinal adenocarcinomas. This case study demonstrates the safety and efficacy of rechallenging oxaliplatin following a moderate HSR in a community oncology setting.
Case: A 65-year-old female received perioperative oxaliplatin. During treatment 6, she developed a moderate HSR after 24 mg of the planned dose. Symptoms included facial flushing, palmar erythema, pruritus, urticaria on the neck/face, tingling/burning sensation of the tongue, and chest discomfort. The patient received normal saline with histamine 1 and 2 blockade per the institutional hypersensitivity protocol. Vital signs remained stable with mild reduction in SpO2. Symptoms resolved and the remaining 109mg of oxaliplatin was discarded.
Intervention: For treatments 7 and 8, a rechallenge protocol with additional premedication (diphenhydramine, famotidine, and dexamethasone) was implemented. A compounding bag contained the entire dose in 100mL dextrose 5% in water (D5W) solution. 0.01mL was removed from the compounding bag, added to a 100mL D5W, and was administered over 1 hour with vital signs monitoring every 15-30 minutes. The same steps were applied with 0.1mL, 1mL, and 10mL. The remaining compounding bag volume was placed in a 500mL D5W solution and administered over 2 hours with vital signs monitoring every 15-30 minutes.
Outcome: The patient completed perioperative treatments 7 and 8 without escalation of HSR severity, showcasing the safety of oxaliplatin rechallenge following a moderate HSR in the community setting.
Recommended Citation
Nalan M. Case Study: Rechallenge Protocol in Managing Oxaliplatin Reactions. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).
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