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Weekly vinblastine in pediatric low-grade glioma patients
with carboplatin allergic reaction
Lafay-Cousin L, Holm S, Qaddoumi I, Nicolin G, Bartels U, Tabori U, Huang
A, Bouffet E
Hospital for Sick Children, Toronto, Canada.
Background. Carboplatin-based regimens have demonstrated activity in
unresectable low-grade glioma (LGG) in children.
Despite an interesting
toxicity profile, the use of these regimens has been limited by the
development of carboplatin hypersensitivity reaction (HSR) in up to 30% of
patients.
Desensitization has been the recommended approach for HSR.
However, no guidelines have existed to aid physicians when carboplatin
desensitization techniques fail.
Methods. A pilot study of monotherapy with
weekly vinblastine for LGG in 9 children who developed carboplatin HSR on a
carboplatin and vincristine regimen was performed.
Results. Vinblastine
toxicity was moderate and readily manageable.
None of the 9 patients had
disease progression on therapy.
Magnetic resonance imaging evaluation of
tumor size from diagnosis to the end of vinblastine treatment showed 1
complete response (CR), 1 partial response (PR), 5 objective effects (OE),
and 2 stable diseases (SD).
Conclusions. This experience suggested that
weekly vinblastine has a good efficacy to toxicity ratio in the treatment of
LGG and can be a valuable option for children who develop severe HSR.
Cancer
2005. (c) 2005 American Cancer Society.
PMID: 15861409 [PubMed - as supplied by publisher]
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