Portal de Periódicos da CAPES

Carboplatin hypersensitivity reactions in patients with ovarian and peritoneal carcinoma

1998; BMJ; Volume: 8; Issue: 5 Linguagem: Inglês

10.1046/j.1525-1438.1998.09838.x

1525-1438

Rose Rose, Fusco, Fluellen, Michael Rodriguez,

Chemotherapy-induced organ toxicity mitigation

Rose PG, Fusco N, Fluellen L, Rodriguez M. Carboplatin hypersensitivity reactions in patients with ovarian and peritoneal carcinoma. Int J Gynecol Cancer 1998; 8:365–368. Platinum is the most active agent in the treatment of ovarian cancer and high response rates with platinum retreatment of patients with recurrent disease have been reported. However, cumulative toxicity of cisplatin and carboplatin allergic reactions may limit further therapy. We describe a retrospective review of patients developing carboplatin allergy from May 1995–May 1998. Fourteen patients with ovarian and peritoneal cancer with carboplatin allergy were identified. In all but one case, patients received paclitaxel immediately prior to the carboplatin therapy. Following carboplatin infusion durations of 5–60 min, patients developed symptoms of a cough, wheezing, flushing, angioedema, burning eyes, pruritus of the hands and tongue, and nausea. No deaths occurred. The median number of courses of carboplatin therapy before an allergic reaction occurred was 9 (range 2–14). Twelve patients were rechallenged with a platinum compound. The first patient was retreated with cisplatin 50 mg/m2 with only a minor allergic response controlled with diphenhydramine hydrochloride. The second patient was retreated with carboplatin but developed a recurrent allergic reaction despite premedication with steroids and diphenhydramine hydrochloride and a 4-hour carboplatin infusion. This patient was successfully rechallenged with a prolonged 16-h carboplatin infusion. Seven additional patients were treated successfully following premedication and the prolonged carboplatin infusion. However, 3 patients had recurrent severe carboplatin allergic reactions despite premedication and the prolonged carboplatin infusion. One of these patients was successfully retreated with cisplatin. Carboplatin allergies rarely have been reported and may be potentiated by coadministration of paclitaxel. Prolonged desensitization regimens are effective in the majority of patients with carboplatin hypersensitivity reactions. Alternatively, retreatment with cisplatin can be considered in the absence of cumulative cisplatin toxicity.