title: An experimental biological test to diagnose hypersensitivity reactions to carboplatin: new horizons for an old problem.
abstract: Carboplatin, a second-generation platinum compound, is a chemotherapeutic drug effective in many types of cancers. Its use is limited by the development of systemic allergic reactions in up to 30% of the cancer patients. Therefore, it is very important to make a correct diagnosis of true carboplatin allergy, for the crucial clinical implications. In this regard, no biological test is actually available to detect specific immunoglobulin E in the sera of patients allergic to carboplatin. We evaluated a new experimental biological test in patients with suspected immunoglobulin E-mediated reactions to carboplatin. Three patients with suspected hypersensitivity reactions to carboplatin underwent skin tests with an undiluted aliquot (10 mg/ml) of carboplatin preparation planned for infusion. Total serum immunoglobulin E and specific immunoglobulin E to the two platinum salts carboplatin and cisplatin were determined with the ImmunoCAP system (Phadia AB, Uppsala, Sweden). We detected specific immunoglobulin E to carboplatin in all three patients, whereas specific immunoglobulin E to cisplatin was observed in one patient. The positivity of specific immunoglobulin E against carboplatin in these three patients is a new and encouraging observation for the development of a new important instrument that can help clinicians in their therapeutic decisions, after a hypersensitivity reaction to a platinum salt.
authors.affiliation: Department of Internal Medicine, Allergology and Oncology Service Asola Hospital, Mantova, Italy. mauro.pagani@aopoma.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Pagani
authors.forename: Lennart
authors.initials: L
authors.lastname: Venemalm
authors.forename: Patrizia
authors.initials: P
authors.lastname: Bonnadona
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Vescovi
authors.forename: Carmen
authors.initials: C
authors.lastname: Botelho
authors.forename: Josefina R
authors.initials: JR
authors.lastname: Cernadas
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016190:Carboplatin / Q000009:adverse effects* / Q000276:immunology; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008875:Middle Aged; D012882:Skin Tests / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents; D007073:Immunoglobulin E; D016190:Carboplatin