Rechallenge to carboplatin in children with low grade glioma and carboplatin hypersensitivity reactions

Antonio Ruggiero*, Daniela Rizzo, Martina Catalano, Palma Maurizi, Stefano Mastrangelo, Giorgio Attina', Riccardo Riccardi

*Corresponding author

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Carboplatin based regimens have demonstrated activity in pediatric patients with low grade gliomas (LGG). However, carboplatin hypersensitivity reactions (CHRs) may be a major problem leading to premature cessation of an effective therapy. The objectives of this study were to describe the prevalence, characteristics and management of CHR. Methods: We performed a retrospective review of children with LGG treated between January 1994 and July 2015 with carboplatin and vincristine who had a documented CHR. We identified two groups: the first was treated following the schema proposed by Packer et al., and re-exposed to carboplatin using a desensitization protocol; the second was treated according to protocol SIOP LGG 2004 and re-exposed with the infusion time prolonged. Results: CHRs were observed in 16 patients (34%) out of 47. Hypersensitivity reactions occurred in 6 patients (20.7%) of the first, and 10 patients (55.5%) of the second group, respectively. The grade 2 reactions were the most common. The median number of carboplatin doses administered at the first episode of CHR was 7 (range, 3-9) for the first group, and 8.5 (range, 5-11) for the second, respectively. Six patients were re-exposed to carboplatin using a desensitization protocol; 10 with a prolonged infusion time. Overall success rate for re-exposition was 43.75% (100% and 10%, respectively) (P = 0.001). Conclusions: Our results show that re-exposure is a safe alternative to abandoning carboplatin. Desensitization showed greater effectiveness compared to a prolonged infusion time, which allowed the patients to receive effective treatment without adverse reactions.
Original languageEnglish
Pages (from-to)179-N/A
JournalFrontiers in Pharmacology
Volume8
DOIs
Publication statusPublished - 2017

Keywords

  • Carboplatin
  • Hypersensitivity
  • Low grade glioma
  • Pharmacology
  • Pharmacology (medical)
  • Re-exposition,children

Fingerprint

Dive into the research topics of 'Rechallenge to carboplatin in children with low grade glioma and carboplatin hypersensitivity reactions'. Together they form a unique fingerprint.

Cite this