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Clinical features and management of carboplatin-related hypersensitivity reactions in pediatric low-grade glioma

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Abstract

Purpose

The effectiveness of carboplatin and vincristine chemotherapy in the treatment of low-grade glioma (LGG) is well established. However, carboplatin hypersensitivity reactions (CHR) are a major problem leading to premature cessation of therapy. We aimed to investigate the clinical features and the management strategies in CHR, retrospectively.

Method

Fifty LGG patients treated between October 1997 and January 2008 with carboplatin and vincristine were included in the study. Clinical features, management strategies, influence of demographic factors on CHR, and success rate in terms of continuation with carboplatin therapy were evaluated.

Results

CHR were observed in 20 (40%) patients and grade I reactions were the most common. The median number of carboplatin doses administered at the first episode of CHR was nine (range 1–41). Only younger age was found to be correlated with the presence of CHR. Nine patients had carboplatin desensitization protocol; eight patients were given various combinations of premedication while three had no modification. Treatment was terminated in five patients due to CHR. Overall success rate was 75%.

Conclusions

This is the largest single-center study conducted to investigate the frequency and the management strategies in patients with CHR who were treated with the same chemotherapy protocol for LGG. Premedication and desensitization were the preferred modifications in case of CHR. Overall, the success rate for carboplatin continuation is high in comparison to previous studies. Carboplatin can be continued successfully in many cases with CHR if reactions are managed in a timely fashion.

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Acknowledgements

This work was partly presented in the 40th Annual Conference of the International Society of Paediatric Oncology SIOP 2008, Berlin, Germany, 2008.

Conflicts of interest

The authors declare that they have neither a financial relationship with any organization nor with any sponsor. They also accept that the primary data which is under their control is allowed to be reviewed by the journal upon request.

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Authors and Affiliations

  1. Pediatric Hematology–Oncology Unit, Marmara University Medical Center, Tophanelioglu Caddesi No: 13/15, Altunizade, 34662, Istanbul, Turkey

    Dildar Bahar Genc, Cengiz Canpolat & Su Gulsun Berrak

  2. Department of Pediatrics, Children’s Hospital at Monmouth Medical Center, Long Branch, NJ, 07740, USA

    Su Gulsun Berrak

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  1. Dildar Bahar Genc
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  2. Cengiz Canpolat
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  3. Su Gulsun Berrak
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Correspondence to Su Gulsun Berrak.

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Genc, D.B., Canpolat, C. & Berrak, S.G. Clinical features and management of carboplatin-related hypersensitivity reactions in pediatric low-grade glioma. Support Care Cancer 20, 385–393 (2012). https://doi.org/10.1007/s00520-011-1123-y

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