Carboplatin Hypersensitivity Reactions in Pediatric Low Grade Glioma Are Protocol Specific and Desensitization Shows Poor Efficacy

Pediatr Blood Cancer. 2016 Jan;63(1):17-20. doi: 10.1002/pbc.25686. Epub 2015 Jul 24.

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.

Keywords: carboplatin; children; desensitization; hypersensitivity; low grade glioma.

MeSH terms

  • Adolescent
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Carboplatin / administration & dosage
  • Carboplatin / adverse effects*
  • Central Nervous System Neoplasms / therapy*
  • Child
  • Child, Preschool
  • Desensitization, Immunologic*
  • Drug Hypersensitivity / therapy*
  • Female
  • Glioma / drug therapy*
  • Humans
  • Infant
  • Male
  • Neoplasm Grading
  • Treatment Failure
  • Vincristine / administration & dosage

Substances

  • Antineoplastic Agents
  • Antineoplastic Agents, Phytogenic
  • Vincristine
  • Carboplatin