Desensitization protocol

[Lara1]

Hello ladies,

After switching to docetaxel due to a strong reaction to taxol, I had a similar reaction although milder to the second docetaxel infusion. So now my doctor wants me to try nab paclitaxel. I know it’s supposed to be less allergenic but the risk is not 0 even with this one. I have a preexisting autoimmune condition which is causing all this reactivity, So I’m’starting to think I will need a desensitization protocol if I am to complete the treatment. Do any of you have experience with such a protocol or have been in similar situation? Thank you, L.

[Cheadle]

I've had it with carboplatin, so instead of a 60 minute treatment, I got it in 4 × 90 minute bags of increasing strength. Also had to take pre meds from 24 hrs before. Not heard of it being done that way with Taxol but it may be possible.

[Alice77 in reply to Cheadle]

Hi. I have had allergic responses to Carboplatin this year and had to stop taking it. Weekly Paclitaxel has not made much difference for me so a desensitization regime with an overnight hospital stay has been suggested. I would be really interested to hear about your experience of this and whether it worked for you. Thanks for your help Best wishes

[Cheadle in reply to Alice77]

I had a reaction to carbo on my 8th infusion. Nothing major, but clearly an allergic reaction, itchy palms, tingling lips etc. I was switched to cisplatin, which was delivered as an overnight treatment ( this was back in 2010. I believe its done as a day treatment now). When I needed chemo again in 2014, they put me on the carbo desensitisation protocol which I have had three times now. So, yes, it definitely worked for me and enabled me to keep having carbo as long as I was responsive. The only real down side is the very long treatment day, usually an 0830 start, finishing in the evening. I would suggest a port to cut down cannulation time, plus makes it easier to move about on the long treatment day, going to the loo etc which always ends up triggering the machines and causing occlusions.

[Alice77 in reply to Cheadle]

Thank you so much for letting me know. This sounds very encouraging. I was a bit sceptical because I have already tried three times with extra antihistamines and steroids, slower infusion rate etc without success but this protocol looks more effective. I do hope so as I have run out of other options.

[delia2]

Hi. I had carboplatin in a desensitization unit at Dana Farber in the US. They could only handle four people a day as it’s very labor intensive. Loads and loads of premeds. They change the concentration of the chemo every hour and the speed of the drip every fifteen minutes. The doctor who invented it is Maria Cassells. It’s been written up as have other protocols. Good luck with it.

[Alice77 in reply to delia2]

Thanks. I read the report and it looks very promising.

[Lara1]

Thank you, ladies. Besides premeds and modified infusion times, has any of you taken treatment post infusion, such as steroids or even immunosuppressants to manage delayed reactions / side effects?