A 49-year-old woman with gastric signet ring cell carcinoma was treated with radical subtotal gastrectomy and oxaliplatin-based regimen for 10 cycles after surgery. However, 2 minutes after starting the 11th course of oxaliplatin regimen, the patient experienced sudden cardio arrest. Oxaliplatin administration was immediately discontinued, cardiopulmonary resuscitation, breathing assistance, intravenous epinephrine and norepinephrine and other treatment were given. She was gradually improved and discharged. It was evaluated by Naranjo's score scale and relevance evaluation methods of National Monitoring Center for ADR in China that the adverse reaction of sudden cardio arrest was “likely” caused by oxaliplatin. Reviewing the relevant literature combined with this case, cardiac toxicity manifested by oxaliplatin-induced anaphylaxis is potentially life-threatening and this severe adverse reaction is difficult to predict and prevent. During clinical use, it should be closely monitored throughout the infusion.

1.Yu Z, Huang R, Zhao L, et al. Safety profile of oxaliplatin in 3,687 patients with cancer in China: a post-marketing surveillance study[J]. Front Oncol, 2021, 11: 827-831. DOI: 10.3389/fonc.2021.757196.

2.罗佳, 姚敦武, 周春花. 静脉滴注奥沙利铂致全身抽搐1例 [J]. 药物流行病学杂志, 2022, 31(2): 135-136. [Luo J, Yao DW, Zhou CH. A case of generalized convulsions induced by oxaliplatin[J]. Chinese Journal of Pharmacoepidemiology, 2022, 31(2): 135-136.] DOI: 10.19960/j.cnki.issn1005-0698.2022.02.012.

3.王妮拉, 龚奎玉, 王桂华. 奥沙利铂过敏致心搏骤停1例[J]. 中南药学, 2020, 18(3): 521- 522. [Wang NL, Gong KY, Wang GH. A case of cardio arrest induced by oxaliplatin[J]. Central South Pharmacy, 2020, 18(3): 521- 522.] DOI: 10.7539/j.issn.1672-2981.2020.03.040.

4.Tamura H, Kameyama H, Toge K, et al. A case of cardiopulmonary arrest due to hypersensitivity reaction to oxaliplatin for multiple liver and lung metastases of colon cancer[J]. Gan to kagaku ryoho. Cancer & chemotherapy, 2014, 41(12): 1844-1845. https://pubmed.ncbi.nlm.nih.gov/25731349.

5.Weidner K, Behnes M, Haas J, et al. Oxaliplatin-induced acute ST segment elevation mimicking myocardial infarction: a case report[J]. Oncol Res Treat, 2018, 41(1-2): 52-56. DOI: 10.1159/000480661.

6.Chang RY, Lee MY, Kan CB, et al. Oxaliplatin-induced acquired long QT syndrome with torsades de pointes and myocardial injury in a patient with dilated cardiomyopathy and rectal cancer[J]. J Chin Med Assoc, 2013, 76(8): 466-469. DOI: 10.1016/j.jcma.2013.05.001.

7.Polyzos A, Tsavaris N, Gogas H, et al. Clinical features of hypersensitivity reactions to oxaliplatin: a 10-year experience[J]. Oncology, 2009, 76(1): 36-41. DOI: 10.1159/000178163.

8.国家药品监督管理局. 个例药品不良反应收集和报告指导原则[EB/OL]. (2018-12-19) [2023-01-12]. https://www.nmpa.gov.cn/xxgk/ggtg/qtggtg/20181221172901438.html.

9.Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions[J]. Clin Pharmacol Ther, 1981, 30(2): 239-245. DOI: 10.1038/clpt.1981.154.

10.美国卫生及公共服务部. 常见不良事件评价标准（CTCAE）5.0版[EB/OL]. (2017-11-27)  [2021-06-20]. http://guide. medlive.cn/.

11.李敏, 钟巧妮, 赵丽, 等. 中国患者奥沙利铂过敏反应文献分析 [J]. 中国药物警戒, 2020, 17(11): 798-802. [Li M, Zhong QN, Zhao L, et al. Literature analysis of oxaliplatin allergic reactions in Chinese patients[J]. Chinese Journal of Pharmacovigilance, 2020, 17(11): 798-802.] DOI: 10.19803/j.1672-8629.2020.11.11.

12.Li M, Jiang C, Yang JW, et al. Clinical features of oxaliplatin-induced hypersensitivity reactions in Chinese patients: a retrospective multicenter analysis[J]. Curr Med Sci, 2021, 41(4): 827-831. DOI: 10.1007/s11596-021-2387-1.

13.Bano N, Najam R, Qazi F, et al. Clinical features of oxaliplatin induced hypersensitivity reactions and therapeutic approaches[J]. Asian Pac J Cancer Prev, 2016, 17(4): 1637-1641. DOI: 10.7314/apjcp.2016.17.4.1637.

14.Parel M, Ranchon F, Nosbaum A, et al. Hypersensitivity to oxaliplatin: clinical features and risk factors [J]. BMC Pharmacol Toxicol, 2014, 15: 1. DOI: 10.1186/2050-6511-15-1.

15.Barbin F, Ghidini M, Panichi A, et al. Oxaliplatin-related hypersensitivity reactions: a single institution series and literature review[J]. Biomedicines, 2022, 10(12): 3275. DOI: 10.3390/biomedicines10123275.

16.Song QY, Cai Y, Guo K, et al. Risk factors for oxaliplatin-induced hypersensitivity reaction in patients with colorectal cancer[J]. Am J Transl Res, 2022, 14(4): 2461-2468. https://pubmed.ncbi.nlm.nih.gov/35559366.

17.Lee MY, Yang MH, Liu JH, et al. Severe anaphylactic reactions in patients receiving oxaliplatin therapy: a rare but potentially fatal complication[J]. Support Care Cancer, 2007, 15(1): 89-93. DOI: 10.1007/s00520-006-0107-9.

18.Aroldi F, Prochilo T, Bertocchi P, et al. Oxaliplatin-induced hypersensitivity reaction: underlying mechanisms and management[J]. J Chemother, 2015, 27(2): 63-66. DOI: 10.1179/1973947814Y.0000000204.

19.Kim BH, Bradley T, Tai J, et al. Hypersensitivity to oxaliplatin: an investigation of incidence and risk factors, and literature review[J]. Oncology, 2009, 76(4): 231-238. DOI: 10.1159/000205263.