Development and implementation of a carboplatin desensitization protocol for children with neurofibromatosis, type 1 and hypersensitivity reactions in an outpatient oncology clinic.
Neurofibromatosis, type 1 (NF 1), is a relatively common disorder. Children with NF 1 are at much greater risk for the development of optic pathway tumors, which are sometimes treated with chemotherapy. As a result, many oncology centers and clinics are now seeing and treating NF patients. One of the most frequently used drugs is carboplatin. However, as many as 30% of NF patients may develop a reaction to carboplatin, which can include anaphylaxis. This often results in the cessation of the medication and treatment protocol. At the Children's Hospital of Philadelphia a desensitization protocol has been instituted with children who have had such reactions and whose tumors have demonstrated a positive response to the treatment. The desensitization process is quite complex and requires an interdisciplinary approach. However, it is the nursing personnel that are key to the successful coordination and delivery of such a protocol in an oncology outpatient clinic on a regular basis.
Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Susan K
SK
Ogle
Margaret M
MM
Rose
Cynthia Tate
CT
Wildes
D000553:Ambulatory Care / Q000379:methods; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016190:Carboplatin / Q000009:adverse effects* / Q000627:therapeutic use; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage; D004155:Diphenhydramine / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004342:Drug Hypersensitivity / Q000209:etiology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009456:Neurofibromatosis 1 / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing; D009859:Oncology Nursing; D010044:Outpatient Clinics, Hospital; D011239:Prednisolone / Q000008:administration & dosage*; D011292:Premedication; D011322:Primary Prevention / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D003907:Dexamethasone; D004155:Diphenhydramine; D011239:Prednisolone; D016190:Carboplatin