title: Carboplatin hypersensitivity: evaluation and successful desensitization protocol.
abstract: OBJECTIVE
  Carboplatin-induced immediate hypersensitivity reactions are relatively common among patients with gynecological malignancies. Once this occurs, the patient might be at risk for future carboplatin-induced reactions. This study evaluated the efficacy of allergic consultation, carboplatin skin testing and desensitization as a single intervention strategy in this population.
  
  
  METHODS
  Patients with a well-documented immediate reaction to carboplatin were offered allergy consultation, carboplatin skin testing and a desensitization plan in a single visit between scheduled chemotherapy sessions.
  
  
  RESULTS
  Fifty-five patients with an immediate reaction were evaluated. After allergist assessment, 44 (89%) of 49 patients skin tested had a positive result. A total of 207 carboplatin desensitization cycles were administered to 49 women. Among them, 10 patients had a mild immediate hypersensitivity reaction during desensitization. Five patients subsequently tolerated carboplatin administered in the prolonged desensitization protocol.
  
  
  CONCLUSIONS
  In the data presented, we propose a strategy that is both cost effective and very convenient for the patient. The diagnostic procedure, including allergist consultation and skin test, can be completed in less than 2 h. In most cases where carboplatin is indispensable, desensitization can be administered without overnight hospitalization.
authors.affiliation: Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Bruchim
authors.forename: Arnon
authors.initials: A
authors.lastname: Goldberg
authors.forename: Ami
authors.initials: A
authors.lastname: Fishman
authors.forename: Ronit
authors.initials: R
authors.lastname: Confino-Cohen
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D016190:Carboplatin / Q000009:adverse effects* / Q000627:therapeutic use; D003888:Desensitization, Immunologic / Q000191:economics; D004342:Drug Hypersensitivity / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy; D012882:Skin Tests
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin
keywords: allergic evaluation; carboplatin allergy; desensitization; ovarian cancer; skin test