title: Carboplatin Hypersensitivity Reactions in Pediatric Low Grade Glioma Are Protocol Specific and Desensitization Shows Poor Efficacy.
abstract: BACKGROUND
  The use of carboplatin for the treatment of pediatric low grade gliomas (PLGG) is often limited by the development of carboplatin hypersensitivity. Reported rates of carboplatin hypersensitivity reactions vary between 6% and 32% in these patients. Here we report the frequency of carboplatin hypersensitivity reactions depending on the treatment regimen used, and outcomes of carboplatin desensitization.
  
  
  METHODS
  The records of all patients in a single institution who were treated with carboplatin for PLGG were accessed and all patients receiving more than one dose of carboplatin are reported.
  
  
  RESULTS
  Thirty four patients with PLGG were treated with carboplatin according to one of the two different regimens. Carboplatin hypersensitivity was documented in 47% of patients, but the frequency differed by treatment protocol. Those patients treated with 4-weekly single agent carboplatin had carboplatin allergy in 8% of cases whereas 68% of those treated with combined carboplatin and vincristine (every three weeks, according to the SIOP 2004 low grade glioma protocol) had carboplatin reactions (OR 23.6, P < 0.01). Desensitization was only successful in two out of 10 patients in whom it was attempted.
  
  
  CONCLUSIONS
  Hypersensitivity reactions to carboplatin are more common in this cohort than previously reported and rates are protocol-dependent. Desensitization showed limited effectiveness in this cohort.
authors.affiliation: Children's Cancer Centre, Royal Children's Hospital, Victoria, Australia.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Dodgshun
authors.affiliation: Children's Cancer Centre, Royal Children's Hospital, Victoria, Australia.
authors.forename: Jordan R
authors.initials: JR
authors.lastname: Hansford
authors.affiliation: Department of Allergy and Immunology, Royal Children's Hospital, Victoria, Australia.
authors.forename: Theresa
authors.initials: T
authors.lastname: Cole
authors.affiliation: Department of Allergy and Immunology, Royal Children's Hospital, Victoria, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Choo
authors.affiliation: Children's Cancer Centre, Royal Children's Hospital, Victoria, Australia.|Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sullivan
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects*; D016543:Central Nervous System Neoplasms / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000628:therapy*; D005260:Female; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D060787:Neoplasm Grading; D017211:Treatment Failure; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine; D016190:Carboplatin
keywords: carboplatin; children; desensitization; hypersensitivity; low grade glioma