Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions

Broome, Charlene B.; Schiff, Richard I.; Friedman, Henry S.

doi:10.1002/(sici)1096-911x(199602)26:2<105::aid-mpo7>3.0.co;2-p

Cited by 53 publications

(13 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the Canadian study, the desensitization protocol consisted of a progressive increase in the rate of carboplatin infusion over various periods (from 1 h to 6 h) according to previously described schedules (doses of 1, 2.5, 5, 10, 25, and 50 mg of carboplatin infused at 1 mg/min every 15 min; the remainder of the dose was infused at the standard rate of 200 mg/h) (Broome et al, 1996; Ogle et al, 2002). Nevertheless, among the 12 patients who underwent desensitization and premedication (antihistamine with or without corticosteroid initiated from 3 days to 1 h before carboplatin infusion), only one patient (8.3%) was able to complete his carboplatin therapy (Lafay-Cousin et al, 2008).…”

Section: Managementmentioning

confidence: 99%

Hypersensitivity to Carboplatin in Children with Malignancy

et al. 2017

View full text Add to dashboard Cite

Purpose: Carboplatin-based regimens have proven efficacy in children with cancer. However, the development of hypersensitivity reactions (HSRs) may have a negative impact on treatment intensity and patients’ outcome. The aim of this review is to summarize the incidence and the clinical features of HSRs occurring in children with cancer treated with carboplatin and their impact on treatment efficacy.Methods: Data were collected by searching for relevant studies on the incidence, clinical features and management of possible side effects about the use of carboplatin in children, published from March 1987 to October 2016 in the PubMed database.Results: Carboplatin HSRs present with mild/moderate to severe clinical patterns. The risk of HSR is related to the cumulative number of infusions. Moreover, a greater risk of developing an HSR has been observed in younger patients than in older age groups of children; risk is also greater in girls and in patients with a prior history of allergy to other drugs. Management options include cessation of carboplatin and switching to another agent, premedication with antihistamines and/or corticosteroids, and carboplatin desensitization. For sensitized patients who have obtained benefits from carboplatin, the continuation of the treatment is desirable and desensitization protocols have showed promising results.Conclusion: Clinicians must not underestimate the potential risk and occurrence of carboplatin HSRs in the pediatric population in order to outline adequate management strategies. Desensitization protocols should be considered for patients sensitive to carboplatin in order to avoid having to discontinue an effective chemotherapy.

show abstract

Section: Managementmentioning

confidence: 99%

Hypersensitivity to Carboplatin in Children with Malignancy

et al. 2017

View full text Add to dashboard Cite

show abstract

“…From 0.01 mg twofold increases every 15 minKim [11]♀, 7, tuberculosisRifampicin and isoniazideDyspnea, rash, pruritusPositiveOralYesStarting dose 0.1 mg, twofold increase every 15 minMorgan [18]♀, 4, astrocytomaCarboplatinFlushing, urticaria, facial edema, coughNDIVYes1–2.5–5–7.5–10–10–25–50-remaining mg. Dose repeated if symptoms occurredBroome [5]♂, 3, astrocytomaCarboplatinCough, congestion, flushing,NegativeIVYes♂, 7, astrocytomaAbdominal pain, erythemaNegative1–2.5–5–10–25 mg iv push q15 min followed by 25–50 mg infusion q15 min, followed by 331 mg 200 mg/hr continuous infusionOgle [19]♀, 3, neurofibromatosisCarboplatinAbdominal discomfort, flushing, increased respiratory effortNRIVYes0.01–0.1–0.5–1.0–2.5–5–10–22.5 mg push q15 min followed by 66 mg over 44 min.Soyer [21]8, ALL E. coli l -asparaginaseAnaphylaxisNRIVYes in 3 casesStarting dose 1 IU, dose doubling every 10 min doseFive uneventful (3 due to anaphylactic reaction during desensitization)Bouchireb [3]♀, 9, astrocytomaMethotrexateUrticariaNDIVYes1/1,000 of full dose in 1.5 h followed by 1/100 in 1.5 h, 1/10 in 6 h and the remaining dose in 24 hCaldeira [7]♂, 9, ALLMethotrexateUrticariaNDIVYes1/1,000 of full dose in 1.5 h followed by 1/100 in 1.5 h, 1/10 in 6 h and the remaining dose in 24 h CF cystic fibrosis, ALL acute lymphatic leukemia, PPL penicilloyl-poly- l -lysine, NR not reported, ND not done…”

Section: Review Of the Literaturementioning

confidence: 99%

Clinical practice

Groot

Mulder

2010

Eur J Pediatr

View full text Add to dashboard Cite

Immediate type allergic reactions to medication are potentially life threatening and can hamper drug therapy of several medical conditions. Exact incidence and prevalence data for these reactions in children are lacking. If no alternative drug treatment is available, a desensitization procedure may secure the continuation of necessary therapy. Desensitization is only appropriate in case of a strong suspicion of an IgE-mediated allergic reaction. It should be performed by trained clinicians (allergy specialists) in a hospital setting where treatment of a potential anaphylactic reaction can be done without any delay. In this article, literature describing desensitization procedures for several antibiotics, antineoplastic agents, and vaccines in children is reviewed. In general, desensitization schemes for children differ only in final dose from schemes for adults. Contradictory data were found regarding the protective effects of premedication with antihistamines and glucocorticoids.

show abstract

“…Children with astrocytomas develop similar rates of HSRs after exposure to several cycles of carboplatin, and desensitizations have been successful in six out of 26 children with HSRs [53]. Two children who received multiple desensitization cycles had stable remission of their astrocyomas [54]. A girl with optic gioma developed a HSR after nine courses of carboplatin and was successfully desensitized [55].…”

Section: Platinum Desensitizations In Childrenmentioning

confidence: 99%