Skip to main content

Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions.

Publication ,  Journal Article
Broome, CB; Schiff, RI; Friedman, HS
Published in: Med Pediatr Oncol
February 1996

Carboplatin is the drug of choice for the treatment of nonresectable astrocytomas in children, but patients who are intolerant may require cranial irradiation which is associated with significant morbidity. Hypersensitivity reactions, including urticaria, bronchospasm, and hypotension, have been reported in 1% to 30% of patients treated with carboplatin. Although a few patients have attempted to continue therapy following pretreatment with antihistamines and corticosteroids, most have had recurrent severe reactions and have discontinued therapy. Two children with a history of severe systemic reactions to carboplatin were pretreated with 1 to 2 mg/kg of oral prednisolone the night before and the morning of their infusion. The initial desensitization was carried out in the intensive care unit (ICU) using doses of 1, 2.5, 5, 10, 25, and 50 mg of carboplatin infused at 1 mg/min every 15 minutes. This was well-tolerated and the remainder of the dose was infused at the standard rate of 200 mg/hr. One patient continued to receive infusions in the clinic without any difficulty. The other patient tolerated a second infusion, but during his third he experienced a systemic reaction that required discontinuation of the infusion and treatment with diphenhydramine. Desensitization was repeated in the ICU with pretreatment with prednisolone, diphenhydramine, and ranitidine, starting with 0.1 mg of carboplatin, and increasing more slowly than in the first protocol. This was well-tolerated, and subsequent infusions have been administered beginning with 1 mg doses without adverse effects. Both boys continued therapy with carboplatin; their astrocytomas are stable and they are clinically well. The use of the desensitization protocol enabled them to avoid cranial irradiation and improved their chances for normal neurologic development.

Duke Scholars

Published In

Med Pediatr Oncol

DOI

ISSN

0098-1532

Publication Date

February 1996

Volume

26

Issue

2

Start / End Page

105 / 110

Location

United States

Related Subject Headings

  • Ranitidine
  • Premedication
  • Prednisolone
  • Oncology & Carcinogenesis
  • Male
  • Infant
  • Humans
  • Histamine H2 Antagonists
  • Drug Hypersensitivity
  • Diphenhydramine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Broome, C. B., Schiff, R. I., & Friedman, H. S. (1996). Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions. Med Pediatr Oncol, 26(2), 105–110. https://doi.org/10.1002/(SICI)1096-911X(199602)26:2<105::AID-MPO7>3.0.CO;2-P
Broome, C. B., R. I. Schiff, and H. S. Friedman. “Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions.Med Pediatr Oncol 26, no. 2 (February 1996): 105–10. https://doi.org/10.1002/(SICI)1096-911X(199602)26:2<105::AID-MPO7>3.0.CO;2-P.
Broome CB, Schiff RI, Friedman HS. Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions. Med Pediatr Oncol. 1996 Feb;26(2):105–10.
Broome, C. B., et al. “Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions.Med Pediatr Oncol, vol. 26, no. 2, Feb. 1996, pp. 105–10. Pubmed, doi:10.1002/(SICI)1096-911X(199602)26:2<105::AID-MPO7>3.0.CO;2-P.
Broome CB, Schiff RI, Friedman HS. Successful desensitization to carboplatin in patients with systemic hypersensitivity reactions. Med Pediatr Oncol. 1996 Feb;26(2):105–110.

Published In

Med Pediatr Oncol

DOI

ISSN

0098-1532

Publication Date

February 1996

Volume

26

Issue

2

Start / End Page

105 / 110

Location

United States

Related Subject Headings

  • Ranitidine
  • Premedication
  • Prednisolone
  • Oncology & Carcinogenesis
  • Male
  • Infant
  • Humans
  • Histamine H2 Antagonists
  • Drug Hypersensitivity
  • Diphenhydramine