Cerebral sinovenous thrombosis and asparaginase re-exposure in patients aged 1-45 years with acute lymphoblastic leukaemia: A NOPHO ALL2008 study.

Autor: Skipper MT; Department of Paediatrics and Adolescent Medicine Aarhus University Hospital Aarhus Denmark.; Department of Clinical Medicine Aarhus University Aarhus Denmark., Rank CU; Department of Paediatrics and Adolescent Medicine Rigshospitalet University Hospital Copenhagen Denmark., Jarvis KB; Department of Paediatric Haematology and Oncology Oslo University Hospital Oslo Norway., Lynggaard LS; Department of Paediatrics and Adolescent Medicine Aarhus University Hospital Aarhus Denmark., Andrés-Jensen L; Department of Paediatrics and Adolescent Medicine Rigshospitalet University Hospital Copenhagen Denmark., Quist-Paulsen P; Department of Haematology Trondheim University Hospital Trondheim Norway., Semaskeviciene R; Oncology and Transfusion Medicine Centre Vilnius University Hospital Santaros Klinikos Vilnius Lithuania., Hallböök H; Department of Medical Sciences Uppsala University Uppsala Sweden., Waitiovaara-Kautto U; Department of Haematology Comprehensive Cancer Centre Helsinki University Hospital and University of Helsinki Helsinki Finland., Ranta S; Astrid Lindgren Children's Hospital Karolinska University Hospital and Childhood Cancer Research Unit Department of Women's and Children's Health Karolinska Institute Stockholm Sweden., Trakymiene S; Clinic of Children's Diseases Faculty of Medicine Vilnius University Vilnius University Hospital Santaros Klinikos Vilnius Lithuania., Abrahamsson J; Department of Paediatrics Institution of Clinical Science Sahlgrenska Academy University of Gothenburg Gothenburg Sweden., Huttunen P; Department of Paediatric Haematology Oncology and SCT New Children's Hospital Helsinki University Hospital Helsinki Finland., Albertsen BK; Department of Paediatrics and Adolescent Medicine Aarhus University Hospital Aarhus Denmark.; Department of Clinical Medicine Aarhus University Aarhus Denmark., Schmiegelow K; Department of Paediatrics and Adolescent Medicine Rigshospitalet University Hospital Copenhagen Denmark., Tuckuviene R; Department of Paediatrics and Adolescent Medicine Rigshospitalet University Hospital Copenhagen Denmark.
Jazyk: angličtina
Zdroj: EJHaem [EJHaem] 2022 Jun 24; Vol. 3 (3), pp. 754-763. Date of Electronic Publication: 2022 Jun 24 (Print Publication: 2022).
DOI: 10.1002/jha2.484
Abstrakt: Cerebral sinovenous thrombosis (CSVT) is a serious complication during asparaginase therapy in patients with acute lymphoblastic leukaemia (ALL). We identified 46 patients with CSVT among 2651 patients (1‒45 years) treated according to the Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL2008 protocol between 2008 and 2018. CSVT cases were prospectively registered in the NOPHO database with retrospective updates. We examined the frequency of asparaginase re-exposure after CSVT, potential factors associated with asparaginase truncation, and sequelae after CSVT. This work was supported by the Danish Cancer Society and the Danish Childhood Cancer Foundation. The 2.5-year cumulative incidence of CSVT was 1.9% (95% confidence interval 1.4%-2.5%). The majority of patients (74%, n  = 31) were re-exposed to asparaginase (with low-molecular-weight heparin coverage), one of whom had a second CSVT, without neurological sequelae. Patients re-exposed to asparaginase were earlier in ALL treatment and lacked more asparaginase doses than non-re-exposed patients at CSVT diagnosis (median 50 vs. 81 days, p  = 0.03; mean 11.2 vs. 8.4 asparaginase doses, p  = 0.04). No other examined factors had an impact on asparaginase re-exposure. At the last follow-up (median 4.5 years after CSVT), 61% of patients had normal neurological status, and 57% had complete recanalisation of CSVT, with no significant difference between patients re-exposed and non-re-exposed to asparaginase. Our results indicate that re-exposure to asparaginase is safe after CSVT during anticoagulation.
Competing Interests: Birgitte Klug Albertsen: Sponsor of the investigator‐initiated trial NOR‐GRASPALL2016. Speaker and/or Advisory Board Honoraria from Erytech (2020) and Servier (2021). Kirsten Brunsvig Jarvis: Honoraria from Bayer (2021). Sonata Trakymiene: Honoraria from Bayer HealthCare, Novo Nordisk, Octapharma, Roche, and Takeda, served on advisory board committees for Novo Nordisk and Roche. Remaining authors declare they have no conflicts of interest.
(© 2022 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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