Weekly vinblastine in pediatric low-grade glioma patients with carboplatin allergic reaction.
BACKGROUND
Carboplatin-based regimens have demonstrated activity in unresectable low-grade glioma (LGG) in children. Despite an interesting toxicity profile, the use of these regimens has been limited by the development of carboplatin hypersensitivity reaction (HSR) in up to 30% of patients. Desensitization has been the recommended approach for HSR. However, no guidelines have existed to aid physicians when carboplatin desensitization techniques fail.


METHODS
A pilot study of monotherapy with weekly vinblastine for LGG in 9 children who developed carboplatin HSR on a carboplatin and vincristine regimen was performed.


RESULTS
Vinblastine toxicity was moderate and readily manageable. None of the 9 patients had disease progression on therapy. Magnetic resonance imaging evaluation of tumor size from diagnosis to the end of vinblastine treatment showed 1 complete response (CR), 1 partial response (PR), 5 objective effects (OE), and 2 stable diseases (SD).


CONCLUSIONS
This experience suggested that weekly vinblastine has a good efficacy to toxicity ratio in the treatment of LGG and can be a valuable option for children who develop severe HSR.
Lafay-Cousin
Lucie
L
Hospital for Sick Children, Toronto, Canada.
Holm
Stefan
S
Qaddoumi
Ibrahim
I
Nicolin
Gary
G
Bartels
Ute
U
Tabori
Uri
U
Huang
Annie
A
Bouffet
Eric
E
D000970:Antineoplastic Agents / Q000009:adverse effects*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016190:Carboplatin / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004342:Drug Hypersensitivity / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D006801:Humans; D006967:Hypersensitivity; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009367:Neoplasm Staging; D010865:Pilot Projects; D014747:Vinblastine / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D014747:Vinblastine; D016190:Carboplatin