Misinterpretation of a Calvert-derived formula leading to carboplatin overdose in two children.
Carboplatin is currently recommended to be dosed according to renal function. In adults, dosing by the Calvert formula is based on evidence that carboplatin clearance closely parallels glomerular filtration rate. Several studies have attempted to validate the Calvert formula and its derivations in pediatrics, but no final consensus has been achieved. As a result, different versions of the original formula exist in the pediatric literature. Other factors may also contribute to confusion when applying the formula to young patients, including the manner in which renal function is measured and reported. We describe how misinterpretation of the Calvert formula resulted in carboplatin overdosing in 2 pediatric patients with high-risk neuroblastoma undergoing peripheral blood stem cell transplantation. Measures to avoid such errors have been instituted.
Liem
Robert I
RI
Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland 21231, USA.
Higman
Meghan A
MA
Chen
Allen R
AR
Arceci
Robert J
RJ
D001830:Body Surface Area; D016190:Carboplatin / Q000008:administration & dosage* / Q000627:therapeutic use*; D002675:Child, Preschool; D062787:Drug Overdose / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D009447:Neuroblastoma / Q000188:drug therapy*
D016190:Carboplatin