| Autor: |
Daley RJ; Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Rajeeve S; Department of Medicine, Icahn School of Medicine/Mount Sinai St. Luke's-West Hospital, New York, NY, USA., Kabel CC; Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Pappacena JJ; Department of Pharmacy, Allegheny Health Network, Pittsburgh, PA, USA., Stump SE; Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Lavery JA; Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Tallman MS; Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Geyer MB; Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Park JH; Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA. |
| Abstrakt: |
Pegaspargase is a modified version of asparaginase with prolonged asparagine depletion. It appears to be safe in adults <40 years old, but has a unique spectrum of toxicities, the risks of which appear to increase with age. The primary objective of this study was to evaluate pegaspargase tolerability and toxicity as assessed by evaluation of incidence and severity of adverse events. Secondary objectives included characterization of the reasons underlying pegaspargase discontinuation, when applicable. Grade 3/4 asparaginase-related toxicities with ≥10% incidence included: hyperbilirubinemia, hyperglycemia, hypertriglyceridemia, hypoalbuminemia, hypofibrinogenemia, and transaminitis. 63% of patients (38 of 60) received all intended doses of pegaspargase, with the most common reasons for discontinuation noted as hypersensitivity (12%), hyperbilirubinemia/transaminitis (8%), and hematopoietic transplantation in complete remission (10%). This study suggests that while hepatotoxicity and other known adverse effects are common, with careful monitoring, pegaspargase can safely be administered to adults with ALL age ≥40 years old. |
