Development and evaluation of a new protocol for the management of immediate hypersensitivity reactions in an oncology outpatient department.
Management of immediate hypersensitivity reactions (HSRs) is an everyday practice issue in oncology. Our primary objective aimed to harmonize the management of HSRs. The second aim was to evaluate the implementation of this new protocol and to describe HSRs in real life settings. First, we held several multidisciplinary meetings to develop an internal consensus. Then, we conducted a prospective assessment. First, this work led to a consensus, resulting in new management guidelines. Second, we identified 25 HSRs involving 23 patients (we treat about 100 patients daily, five days a week). On average, a reaction occurred every 9.8 days. According to Brown's classification, our observations included 9 grade 3 HSRs (36%), 9 grade 2 HSRs (36%), and 7 grade 1 HSRs (28%). Most frequent treatments involved in grade 3 HSRs were: Paclitaxel 3 cases (33%), Carboplatin 3 cases (33%) and Cetuximab 2 cases (22%). Following HSR, we observed a change in the planned anti-cancer treatment strategy in 76% of cases. Our work has standardized the management of HSRs in our cancer hospital. It also allows for close monitoring of HSRs, enabling us to understand them more clearly.