Venous thromboembolism incidence associated with pegylated asparaginase (ASP) compared to the native L-ASP: A retrospective analysis with an ASP-based protocol in adult patients with acute lymphoblastic leukaemia.

Autor: Chen R; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Atenafu EG; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Seki J; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Liu X; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Chan S; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Gupta V; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Maze D; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Shuh AC; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Minden MD; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Yee K; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Schimmer AD; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada., Sibai H; Princess Margaret Cancer Centre University Health Network, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2023 May; Vol. 201 (4), pp. 645-652. Date of Electronic Publication: 2023 Feb 16.
DOI: 10.1111/bjh.18683
Abstrakt: Venous thromboembolism (VTE) is a well-known complication in patients with acute lymphoblastic leukaemia (ALL) receiving asparaginase (ASP)-based chemotherapy, including the ASP-intensive Dana-Farber Cancer Institute (DFCI) 91-01 protocol for adults. Since 2019, native L-ASP is no longer available in Canada and was replaced by pegylated (PEG)-ASP. To determine whether the incidence of VTE has changed since switching from L-ASP to PEG-ASP, we conducted a single-centred retrospective cohort study. We included 245 adult patients with Philadelphia chromosome negative ALL between 2011 and 2021, with 175 from the L-ASP group (2011-2019) and 70 from the PEG-ASP group (2018-2021). During Induction, 10.29% (18/175) of patients who received L-ASP developed VTE, whereas 28.57% (20/70) of patients who received PEG-ASP developed VTE (p = 0.0035; odds ratio [OR] 3.35, 95% confidence interval [CI] 1.51-7.39), after adjusting for line type, gender, history of VTE, platelets at diagnosis. Similarly, during Intensification, 13.64% (18/132) of patients had VTE on L-ASP while 34.37% (11/32) of patients on PEG-ASP developed VTE (p = 0.0096; OR 3.96, 95% CI 1.57-9.96 with multivariable analysis). We found that PEG-ASP is associated with a higher incidence of VTE compared to L-ASP, both during Induction and Intensification, despite the administration of prophylactic anticoagulation. Further VTE mitigation strategies are needed in particular for adult patients with ALL receiving PEG-ASP.
(© 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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