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Carboplatin Rechallenge After Hypersensitivity Reactions in Pediatric Patients With Low‐Grade Glioma
Author(s) -
Shah Amish C.,
Minturn Jane E.,
Li Yimei,
Belasco Jean B.,
Phillips Peter C.,
Kang Tammy I.,
Cole Kristina A.,
Waanders Angela J.,
Pollack Rosanna,
Didomenico Concetta,
Wildes Cynthia,
Fisher Michael J.
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25697
Subject(s) - carboplatin , medicine , premedication , desensitization (medicine) , regimen , hypersensitivity reaction , vincristine , anesthesia , blood cancer , chemotherapy , oncology , cancer , cyclophosphamide , cisplatin , receptor
Background The high prevalence of carboplatin hypersensitivity reactions (HSR) significantly affects the treatment of pediatric patients with low‐grade glioma (LGG). Rechallenging patients is an option that must balance the risks of repeat allergic reaction to the benefits of retaining an effective anti‐tumor regimen. Procedure We performed a retrospective review of children with LGG treated with carboplatin and vincristine between October 2000 and April 2013, who had a documented HSR to carboplatin. Patients were re‐exposed to carboplatin using either precautionary measures (prolonged infusion time and premedication with H1 antagonists, H2 antagonists, and corticosteroids), a desensitization protocol, or both. Results We report the results of our institutional experience of carboplatin re‐exposure using both premedication with a prolonged infusion time and a desensitization protocol. Overall, 40 of 55 (73%) patients were successfully rechallenged with carboplatin, including 19 of 25 (76%) patients who underwent desensitization. Conclusion Our results demonstrate re‐exposure to be a safe alternative to abandoning carboplatin for patients with a hypersensitivity reaction. We propose a clinical algorithm for treatment. Pediatr Blood Cancer 2015; 9999:1–6 © 2015 Wiley Periodicals, Inc.