Affiliations: Divisions of Immunology/Allergology, University
Children's Hospital of Zurich, Switzerland | Divisions of Oncology, University Children's Hospital
of Zurich, Switzerland
Note: [] Correspondence: PD Dr. Michael A. Grotzer, University Children's
Hospital Steinwiesstrasse 75 CH-8032 Zurich, Switzerland. Tel: 011 41 1 266
7111, fax: 011 41 1 266 7171. E-mail: Michael.Grotzer@kispi.unizh.ch
Abstract: The prognosis of pediatric low-grade gliomas is relatively
favorable, but unresectable progressive tumors remain a challenge. Chemotherapy
including carboplatin-containing regimens can delay the need for radiation
therapy in young children. However, hypersensitivity reactions to carboplatin
can at times be a severe complication. We have retrospectively evaluated and
characterized the hypersensitivity reactions associated with carboplatin
administration in pediatric low-grade glioma patients treated on an outpatient
basis according to the SIOP/GPOH (International Society of Pediatric
Oncology/Gesellschaft für Pädiatrische Onkologie und
Hämatologie) low-grade glioma 1996 protocol, and also reviewed the
literature. Of nine patients consecutively treated with carboplatin, seven
(78%) developed carboplatin hypersensitivity reactions. The first
hypersensitivity reactions (always grade 2) occurred after a median of nine
courses (range, 7–12). Although desensitization has been used successfully,
there have been reports of severe cases of allergic reaction to carboplatin
despite desensitization, including anaphylaxis and death. Since carboplatin
hypersensitivity reactions are common and desensitization has not been proven
to be safe, efforts should be made to design future therapy protocols for
low-grade gliomas with clear guidelines on how to substitute carboplatin when
hypersensitivity reactions occur. (J Pediatr Neurol 2004; 2(3): 153–157).
