Journal of Clinical Oncology, 2006 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 24, No 18S (June 20 Supplement), 2006: 9053
© 2006 American Society of Clinical Oncology

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Abstract

Carboplatin hypersensitivity reaction in pediatric low grade glioma (LGG) patients: A national experience. On behalf of the Canadian Pediatric Brain Tumor Consortium

Canadian Pediatric Brain Tumor Consortium; Hospital for Sick Children, Toronto, ON, Canada; British Columbia’s Children’s Hospital, Vancouver, BC, Canada; Montreal’s Children’s Hospital, Montreal, PQ, Canada; Stolery Children’s Hospital, Edmonton, AB, Canada; Children’s Hospital of Western Ontario, London, ON, Canada; Alberta Children’s Hospital, Calgary, AB, Canada; McMaster University Medical Center, Hamilton, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

9053

Background: Carboplatin based regimens are widely used in the treatment of unresectable pediatric LGG. Carboplatin hypersensitivity reaction (CHSR) represents a main limiting factor. Objective: To analyse the incidence, characteristics, management and impact on outcome of CHSR. Methods: National retrospective review of children diagnosed with LGG between 1988 and 2004. Inclusion criteria were age <18 years, pathology proven diagnosis of LGG except in NF1 patients, and no chemotherapy or radiotherapy prior to carboplatin chemotherapy. Results: 105 patients (61F/44M) from 10 Canadian centers were included in the study. Median age at diagnosis was 3.5y (0.3–16.8). 33 patients had NF1, 75 had diencephalic tumor. Carboplatin was given monthly or weekly respectively in 46 and 59 patients. 44 (41.9%) patients developed carboplatin HSR at a median time of 6.5 months (0.4–15.4), after a median number of 10.5 (3–39) injections. CHSR occurred significantly earlier with the weekly schedule (p=0.016). Cumulative incidence of CHSR increased with the number of injections with no plateau. Female had significant higher risk to develop CHSR (p=0.02) whereas age, NF1 status and schedule of administration were not significant risk factors. First allergic reaction was rated grade I, II in 36 patients (82%). 34 patients were reexposed to carboplatin with desensitization/premedication, allowing 14 patients (41.2%) to complete their treatment. But the majority (58.8%) had recurrent allergic reaction with a significant worsening of their symptoms (p=0.039). The median number of additional Carboplatin injections delivered was 4 (0.5–34). After Carboplatin discontinuation, 18 patients were switched to another chemotherapy regimen. 5 years PFS was not significantly different in allergic and non allergic patients (53.9% and 45.6%). Conclusions: In our experience, the incidence of CHSR is high (41.9%). Female have higher risk of CHSR. Desensitization/premedication has limited efficacy and does not prevent worsening of CHSR. CHSR did not impact the PFS. However many patients did switch to another chemotherapy regimen and the total duration of treatment was comparable in both groups.

No significant financial relationships to disclose.

Abstract presentation from the 2006 ASCO Annual Meeting