Andrew J Dodgshun1, Jordan R Hansford1, Theresa Cole2, Sharon Choo2, Michael J Sullivan1,3. 1. Children's Cancer Centre, Royal Children's Hospital, Victoria, Australia. 2. Department of Allergy and Immunology, Royal Children's Hospital, Victoria, Australia. 3. Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: The use of carboplatin for the treatment of pediatric low grade gliomas (PLGG) is often limited by the development of carboplatin hypersensitivity. Reported rates of carboplatin hypersensitivity reactions vary between 6% and 32% in these patients. Here we report the frequency of carboplatin hypersensitivity reactions depending on the treatment regimen used, and outcomes of carboplatin desensitization. METHODS: The records of all patients in a single institution who were treated with carboplatin for PLGG were accessed and all patients receiving more than one dose of carboplatin are reported. RESULTS: Thirty four patients with PLGG were treated with carboplatin according to one of the two different regimens. Carboplatin hypersensitivity was documented in 47% of patients, but the frequency differed by treatment protocol. Those patients treated with 4-weekly single agent carboplatin had carboplatin allergy in 8% of cases whereas 68% of those treated with combined carboplatin and vincristine (every three weeks, according to the SIOP 2004 low grade glioma protocol) had carboplatin reactions (OR 23.6, P < 0.01). Desensitization was only successful in two out of 10 patients in whom it was attempted. CONCLUSIONS: Hypersensitivity reactions to carboplatin are more common in this cohort than previously reported and rates are protocol-dependent. Desensitization showed limited effectiveness in this cohort.
BACKGROUND: The use of carboplatin for the treatment of pediatric low grade gliomas (PLGG) is often limited by the development of carboplatinhypersensitivity. Reported rates of carboplatinhypersensitivity reactions vary between 6% and 32% in these patients. Here we report the frequency of carboplatinhypersensitivity reactions depending on the treatment regimen used, and outcomes of carboplatin desensitization. METHODS: The records of all patients in a single institution who were treated with carboplatin for PLGG were accessed and all patients receiving more than one dose of carboplatin are reported. RESULTS: Thirty four patients with PLGG were treated with carboplatin according to one of the two different regimens. Carboplatinhypersensitivity was documented in 47% of patients, but the frequency differed by treatment protocol. Those patients treated with 4-weekly single agent carboplatin had carboplatinallergy in 8% of cases whereas 68% of those treated with combined carboplatin and vincristine (every three weeks, according to the SIOP 2004 low grade glioma protocol) had carboplatin reactions (OR 23.6, P < 0.01). Desensitization was only successful in two out of 10 patients in whom it was attempted. CONCLUSIONS:Hypersensitivity reactions to carboplatin are more common in this cohort than previously reported and rates are protocol-dependent. Desensitization showed limited effectiveness in this cohort.
Authors: Antonio Ruggiero; Daniela Rizzo; Martina Catalano; Giorgio Attinà; Riccardo Riccardi Journal: Front Pharmacol Date: 2017-04-12 Impact factor: 5.810