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Safe administration of chemotherapy in mast cell activation syndrome

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Title: Safe administration of chemotherapy in mast cell activation syndrome
Authors: Lythgoe, MP
Krell, J
McNeish, IA
Tookman, L
Item Type: Journal Article
Abstract: Introduction Mast Cell Activation Syndrome (MCAS) is an immunogenic disorder typically presenting with episodic multi-organ symptoms, caused by the inappropriate and aberrant release of mast cell mediators. Symptoms may be severe, including anaphylaxis and often occur in response to specific triggers which include many drugs and potentially chemotherapeutic agents. The administration of adjuvant chemotherapy and radiotherapy in endometrial cancer significantly reduces the risk of reoccurrence in patients with high risk disease. Currently there is no evidence or case reports to guide the safe administration of chemotherapy in MCAS patients. Case report We present the case of a 59-year-old lady with stage 3 A grade 2 endometroid endometrial cancer who underwent successful surgical management. She then received 4 cycles of adjuvant chemotherapy in the form of carboplatin and paclitaxel. This case describes a staged approach to chemotherapy administration and the utilisation of a carboplatin desensitization regimen to reduce the risk of immediate and delayed hypersensitivity sequalae. Management & outcome: Utilising an enhanced pre-medication strategy and a staged approach to chemotherapy administration, she was able to complete adjuvant treatment without any serious complications. At the date of censoring (May 2020) she has not shown any evidence of disease re-occurrence. Discussion & conclusion: Administering chemotherapy to patients with any mast cell disorder remains challenging. We hope that this case may provide the framework for safer chemotherapy administration for any patients at high risk of serious hypersensitivity sequalae in endometrial cancer and beyond.
Issue Date: 1-Jun-2021
Date of Acceptance: 9-Aug-2020
URI: http://hdl.handle.net/10044/1/83238
DOI: 10.1177/1078155220953879
ISSN: 1078-1552
Publisher: SAGE Publications
Start Page: 1005
End Page: 1010
Journal / Book Title: Journal of Oncology Pharmacy Practice
Volume: 27
Issue: 4
Copyright Statement: © The Author(s) 2020. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
Pharmacology & Pharmacy
Mast Cell activation syndrome
endometrial cancer
carboplatin
carboplatin desensitization
paclitaxel
HYPERSENSITIVITY REACTIONS
CANCER
RISK
CARCINOMA
CLASSIFICATION
MASTOCYTOSIS
Mast Cell activation syndrome
carboplatin
carboplatin desensitization
endometrial cancer
paclitaxel
Oncology & Carcinogenesis
1115 Pharmacology and Pharmaceutical Sciences
Publication Status: Published
Open Access location: https://journals.sagepub.com/doi/10.1177/1078155220953879
Online Publication Date: 2020-10-09
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine



This item is licensed under a Creative Commons License Creative Commons