Allergic reactions to carboplatin

Hendrick, Alex; Simmons, Debra L.; Cantwell, B. M. J.

doi:10.1093/oxfordjournals.annonc.a058160

Cited by 44 publications

(19 citation statements)

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“…As described by others [5, 6, 7, 8, 9, 10], as well as shown in this communication, hypersensitivity reactions to carboplatin usually develop after multiple courses of treatment. Therefore, the paucity in medical literature regarding carboplatin-associated hypersensitivity reactions is most probably related to its use for a limited number of courses, i.e.…”

Section: Discussionsupporting

confidence: 63%

“…Systemic reactions which manifested as anaphylactic shock, asthma or urticaria have been described in a number of patients in the original phase II studies when cisplatin was first introduced in cancer chemotherapy [2, 3, 4]. Hypersensitivity reactions to the cisplatin analogue carboplatin have also been reported in the past but appeared to be less common, with an unpredictable course [6, 7, 8, 9]. Over the past decade, carboplatin has become a very useful agent in several malignancies because of its relative lack of nephrotoxicity and neurotoxicity and its low emetogenic effect compared to cisplatin.…”

Section: Introductionmentioning

confidence: 99%

“…As a result of its extensive use, a significant number of cases of the so-called carboplatin-associated hypersensitivity reactions have been documented [10]. The most distinct clinical feature of these reactions was that the initial episode occurred to otherwise non-allergic individuals after administration of a significant number of courses [5, 6, 7, 8, 9, 10]. In a recent systematic study by Markman et al [10], the incidence of hypersensitivity reactions to carboplatin reached 15% when the drug was administered as the 8th course of treatment, or as the second dose after re-introduction of the agent during second-line chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Hypersensitivity Reactions to Carboplatin Administration Are Common but Not Always Severe: A 10-Year Experience

Polyzos¹,

Tsavaris²,

Kosmas³

et al. 2001

Oncology

126

103

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We have retrospectively evaluated and characterized the hypersensitivity reactions associated with carboplatin administration in ovarian cancer patients treated mainly on an outpatient basis at the Laikon Hospital from 1988 to 1998. A total of 240 patients, who had never been exposed to platinum compounds previously, received carboplatin plus cyclophosphamide (n = 58) or paclitaxel (n = 136) intravenously, and intraperitoneal carboplatin plus intravenous cyclophosphamide (n = 46). The median number of carboplatin courses was 6 (range 3–12) and 5 (range 4–6) for the intravenous and intraperitoneal treatment regimens, respectively. Thirty-two of 194 patients (16%) who were on intravenous carboplatin treatment developed symptoms compatible with a hypersensitivity reaction to carboplatin, that was always verified by manifestation of at least similar symptoms on rechallenging. In contrast, in the group of 46 patients on intraperitoneal carboplatin treatment, no hypersensitivity reaction was ever noticed. Hypersensitivity reactions always occurred after administration of the first 4 intravenous courses of carboplatin; 4, 19, 4, and 5 reactions occurred at the 5th, 6th, 7th, and 8th courses, respectively. These reactions could be distinguished in: (a) mild hypersensitivity reactions in 20 of 194 patients, which manifested as itching (20 patients) and small area erythema plus erythema of the palms and soles (12 patients), occurring either during intravenous injection when most of the drug scheduled had been administered, or within 3 days, and (b) in severe reactions in 12 of 194 patients, which manifested acutely as itching, diffuse erythroderma, rigor, facial swelling, throat and chest tightness, tachycardia (12 patients) and bronchospasm (2 patients), and hypertension or hypotension in 8 and 4 patients, respectively. With appropriate symptomatic management, discontinuation of carboplatin treatment was not required in patients with mild hypersensitivity reactions, but none of the 12 patients with severe reactions was able to receive a full subsequent dose of carboplatin on rechallenging. However, in 4 of these 12 patients carboplatin was replaced by cisplatin, which was given for 4–6 courses without side effects. These findings indicate that although hypersensitivity reactions are common in general, occurring in almost 1 of every 6 patients treated intravenously with carboplatin, their clinical picture is variable, leading to discontinuation of treatment in only 6% of patients. This is not the case when the intraperitoneal route of carboplatin administration is used when indicated.

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Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hypersensitivity Reactions to Carboplatin Administration Are Common but Not Always Severe: A 10-Year Experience

Polyzos¹,

Tsavaris²,

Kosmas³

et al. 2001

Oncology

126

103

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“…Although the drug has a favorable safety profile, hypersensitivity reactions to carboplatin are not rare. [2][3][4][5][6] We showed that in women with an apparent allergic reaction to this drug and a positive skin test to carboplatin, readministration of the drug with a desensitization protocol is safe. Moreover, with this strategy, multiple treatments are feasible without allergic side effects.…”

Section: Discussionmentioning

confidence: 99%

“…1 Nevertheless, with the extensive use of carboplatin, it has become evident that recurrent courses of the drug expose patients to the risk of developing hypersensitivity reactions. [2][3][4][5][6] These reactions can be either mild cutaneus eruptions or more serious anaphylactic symptoms such as hypotension, bronchospasm, and cardiovascular collapse. 7 The current data suggest that most of the reactions are immunologically mediated.…”

mentioning

confidence: 99%

Successful carboplatin desensitization in patients with proven carboplatin allergy

Confino‐Cohen

Fishman

Altaras

et al. 2005

Cancer

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We present the first all‐atom model for the structure of a T = 3 virus, pariacoto virus (PaV), which is a nonenveloped, icosahedral RNA virus and a member of the Nodaviridae family. The model is an extension of the crystal structure, which reveals about 88% of the protein structure but only about 35% of the RNA structure. New modeling methods, combining coarse‐grained and all‐atom approaches, were required for developing the model. Evaluation of alternative models confirms our earlier observation that the polycationic N‐ and C‐terminal tails of the capsid proteins must penetrate deeply into the core of the virus, where they stabilize the structure by neutralizing a substantial fraction of the RNA charge. This leads us to propose a model for the assembly of small icosahedral RNA viruses: nonspecific binding of the protein tails to the RNA leads to a collapse of the complex, in a fashion reminiscent of DNA condensation. The globular protein domains are excluded from the condensed phase but are tethered to it, so they accumulate in a shell around the condensed phase, where their concentration is high enough to trigger oligomerization and formation of the mature virus. © 2009 Wiley Periodicals, Inc. Biopolymers 91: 530–538, 2009. This article was originally published online as an accepted preprint. The “Published Online” date corresponds to the preprint version. You can request a copy of the preprint by emailing the Biopolymers editorial office at biopolymers@wiley.com

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Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions

Broome

Schiff

Friedman

1996

Med. Pediatr. Oncol.

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Allergic reactions to carboplatin

Cited by 44 publications

References 1 publication

Hypersensitivity Reactions to Carboplatin Administration Are Common but Not Always Severe: A 10-Year Experience

Hypersensitivity Reactions to Carboplatin Administration Are Common but Not Always Severe: A 10-Year Experience

Successful carboplatin desensitization in patients with proven carboplatin allergy

Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions

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