Carboplatin hypersensitivity reactions: a single institution experience.
Carboplatin-related hypersensitivity reactions, frequently encountered in the heavily pretreated subpopulation of patients with gynecologic malignancies, can be severe and even potentially lethal-precluding these patients from an effective salvage treatment. We describe our experience in the management of such reactions and the application of a pretreatment protocol with corticosteroids, antihistamines and a slow infusion rate in order to safely re-administer carboplatin to the above patients. From 1998 to 2004, twenty patients developed an allergic reaction to carboplatin. Sixteen of them (80%) suffered from ovarian cancer. Upon resolution of the acute reaction, thirteen patients were pretreated according to our protocol and were re-exposed to carboplatin. Fifteen patients experienced the reaction during second-line carboplatin-based treatment and 5 patients after 3 or more regimens. Fifteen of the reactions (75%) were severe. Thirteen patients were re-treated with carboplatin after the application of our protocol, all of them successfully, even though 10 patients (77%) experienced minor symptoms during subsequent courses. On the contrary, only one of the 6 patients who were re-treated without the application of the protocol was able to receive further platinum-based treatment. In conclusion, pretreatment with corticosteroids, antihistamines and a slower infusion rate may make re-treatment possible in patients having experienced hypersensitivity to carboplatin.
Zorzou
M P
MP
Department of Clinical Therapeutics, Medical School, University of Athens, Athens, Greece.
Efstathiou
E
E
Galani
E
E
Bozas
G
G
Kastritis
E
E
Papadimitriou
C
C
Dimopoulos
M A
MA
Bamias
A
A
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000209:etiology*; D016889:Endometrial Neoplasms / Q000150:complications / Q000188:drug therapy; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000150:complications / Q000188:drug therapy; D010534:Peritoneal Neoplasms / Q000150:complications / Q000188:drug therapy; D016879:Salvage Therapy; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D006634:Histamine H1 Antagonists; D003907:Dexamethasone; D016190:Carboplatin; D008775:Methylprednisolone