Successful Desensitization in a Child with Carboplatin Allergy: A Case Report

Hypersensitivity to platinum is described, although its mechanism is unknown. Carboplatin and cisplatin are cytotoxic agents containing platinum. Carboplatin is used to treat childhood tumors. Desensitization to carboplatin has been reported with some protocols requiring more than 3 days duration. We present a 30-month-old Mexican boy with hypothalamic astrocytoma, ventriculoperitoneal (VP) shunt, and hypersensitivity to carboplatin that developed after six courses of treatment. His symptoms included wheezing and mild urticaria. He failed two attempts before successfully completing three desensitizations with the following regimen: hydroxyzine 2 mg/kg/d and prednisolone 4 mg/kg/d begun at 48 hours prior to the carboplatin infusion, ranitidine 2 mg/kg/d at 24 hours. Carboplatin (1 mg/mL) was given at an initial rate of 1 mg/h with increments every 15 minutes (2, 4, 8,16, 32, 40 mg/h). He experienced mild wheezing at 40 mg/h and responded well to steroids, diphenhydramine, and nebulized albuterol. The infus...