| Carboplatin desensitization. | |
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MedLine Citation:
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PMID: 15328672 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: IgE-mediated carboplatin hypersensitivity reactions occur in up to 30% of patients receiving this agent for chemotherapy of solid tumors, thus limiting therapeutic options. OBJECTIVE: To describe our experience with intravenous carboplatin desensitization regimens, which culminated in a standardized, successful protocol for safe administration. METHODS: Eight consecutive patients with ovarian cancer who had experienced severe anaphylactic reactions to carboplatin were referred to our hospital. Intradermal skin testing was performed by raising a 3-mm bleb by injection of undiluted carboplatin at 10 mg/mL, and the wheal size was read at 20 minutes. The outcomes of the various desensitization regimens were documented prospectively, and the experience gained was used to develop a standardized protocol for administration. RESULTS: All patients had positive intradermal skin test results. The first 3 patients were treated with short (90 minutes to 6 hours) desensitization protocols, and all protocols failed on the first or second infusions. These 3 and a subsequent 5 patients were given intravenous carboplatin according to a protocol of gradual dose escalation over a 4-log dose range given during a 4-day period, with subsequent 3-weekly infusions given more rapidly by omitting the most dilute log dose on each occasion. All patients tolerated the longer infusion protocol without event, and all but 1 patient experienced appropriate tumor marker response. CONCLUSIONS: Short carboplatin desensitization protocols (less than 6 hours) have an unacceptable failure rate in patients with carboplatin allergy, but longer infusion times (days) are well tolerated without recurrence of the allergic reaction and with good tumor response. In cases where carboplatin is the optimal therapeutic agent, clinicians should not be deterred by an anaphylactic reaction to it or by failure of shorter desensitization regimens. |
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Authors:
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James Choi; Paul Harnett; David A Fulcher |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology Volume: 93 ISSN: 1081-1206 ISO Abbreviation: Ann. Allergy Asthma Immunol. Publication Date: 2004 Aug |
Date Detail:
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Created Date: 2004-08-26 Completed Date: 2004-09-23 Revised Date: 2006-04-24 |
Medline Journal Info:
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Nlm Unique ID: 9503580 Medline TA: Ann Allergy Asthma Immunol Country: United States |
Other Details:
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Languages: eng Pagination: 137-41 Citation Subset: IM |
Affiliation:
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Immunology Unit, Westmead Hospital, Westmead, Sydney, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anaphylaxis / chemically induced, diagnosis Antineoplastic Agents / administration & dosage, adverse effects* Antineoplastic Combined Chemotherapy Protocols / therapeutic use Australia Carboplatin / administration & dosage, adverse effects* Desensitization, Immunologic* Dose-Response Relationship, Drug Drug Hypersensitivity / diagnosis, etiology Female Humans Infusions, Intravenous Middle Aged Neoplasm Staging Ovarian Neoplasms / drug therapy, pathology Paclitaxel / administration & dosage Skin Tests Women's Health |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 33069-62-4/Paclitaxel; 41575-94-4/Carboplatin |
| Comments/Corrections | |
Comment In:
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Ann Allergy Asthma Immunol. 2004 Aug;93(2):111
[PMID:
15328668
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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