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Allergic to Carboplatin

  • Package Insert Indicates
    • 2% of patients will have an allergic reaction to carboplatin upon first use
  • Research Shows
    • The more chemotherapy sessions, the higher the likelihood of an allergic reaction
      • In initial treatment, with carboplatin used for 6 cycles or less, the probability of an allergic reaction is 1%;
      • With more than 7 cycles, the probability of an allergic reaction is 27%;
      • With more than 15 cycles, the probability of an allergic reaction increases to 46%;
      • The probability of an allergic reaction gradually increases after the 8th cycle
      • Allergic reactions usually peak after the 2nd to 3rd cycle of carboplatin re-administration following tumor recurrence
    • The higher the cumulative dose of platinum, the higher the likelihood of an allergic reaction
      • When the cumulative dose of platinum exceeds 3500mg, the probability of an allergic reaction is approximately 74.3%
      • When the cumulative dose exceeds 8000mg, severe allergic reactions may occur, even life-threatening
    • Interval between platinum administrations and allergic reactions
      • An interval of more than 12 months between two carboplatin chemotherapy sessions is also a factor in carboplatin sensitization
  • Desensitization therapy can be used during allergic reactions
    • Common 6-hour desensitization therapy
    • Initially prepare 4 concentrations of carboplatin solutions
    • The first three carboplatin solutions have concentrations containing 1/1000, 1/100, and 1/10 of the total dose of carboplatin, respectively
    • Dilute all in 150ml of 5% glucose solution
    • The remaining portion of the total dose is the fourth concentration
    • Start infusion with the 1/1000 concentration of carboplatin solution,
    • Infusion time for each concentration of carboplatin solution is over 90 minutes
    • If the infusion of the previous lower concentration solution goes smoothly, immediately administer the next higher concentration of carboplatin
    • Symptomatic treatment with antiallergic and antiemetic drugs is given before infusing the carboplatin solution
  • photo by Diana Polekhina on Unsplash
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