Chinese expert consensus on whole-process management of oxaliplatin-induced hypersensitivity reactions(2024 edition)
中国抗癌协会肿瘤整体评估专业委员会 福建省抗癌协会癌痛专业委员会 苏丽玉 潘莹 林榕波
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摘要
奥沙利铂是多种恶性肿瘤治疗的基石药物.超敏反应是奥沙利铂令人困扰的不良反应之一,可能危及患者生命,常迫使医师停用奥沙利铂,转寻其他替代方案,而这些替代方案可能效果更差、耐受性更低和(或)价格更昂贵.奥沙利铂超敏反应主要表现为经典的Ⅰ型过敏反应,另外还包含细胞因子释放反应及混合型.临床上最关注的是严重过敏反应的管理以及针对发生超敏反应后奥沙利铂再挑战的问题.因此,本专家组基于国内外循证医学证据,结合临床实践经验,对奥沙利铂超敏反应的定义、临床特征、诊断、分类与分级标准、处理以及再挑战进行充分的评估与讨论,最终形成《奥沙利铂超敏反应全程管理中国专家共识(2024年版)》,以便进一步规范对奥沙利铂超敏反应的全程管理.本共识已在国际实践指南注册与透明化平台(Practice guideline REgistration for transPAREncy,PREPARE)上注册,注册编号为 PREPARE-2024CN371.
Abstract
Oxaliplatin serves as a basic therapeutic agent for various malignant tumors.Oxaliplatin-induced hypersensitivity reactions are potentially life-threatening,and frequently lead to treatment discontinuation.Alternative therapies may be less effective and/or more expensive,with varying tolerability.Oxaliplatin hypersensitivity reactions typically manifest as a classic type Ⅰ allergy,as well as cytokine release reactions and mixed types.In clinical practice,management of anaphylaxis and questions relative to rechallenge with oxaliplatin after occurrence of hypersensitivity reactions are of utmost concern.Therefore,based on evidence-based medicine and clinical practice experience,the expert panel carried out a comprehensive assessment and discussion on the definition,clinical characteristics,diagnosis,classification and grading criteria,management,and rechallenge of hypersensitivity reactions to oxaliplatin.Eventually,the"Chinese expert consensus on whole-process management of oxaliplatin-induced hypersensitivity reactions(2024 edition)"was formulated to further standardize the whole-process management of oxaliplatin-induced hypersensitivity reactions.The consensus has been registered on Practice guideline REgistration for transPAREncy(PREPARE)with the registration number PREPARE-2024CN371.
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