Safety of re-challenging adults with acute lymphoblastic leukemia with PEG-asparaginase-induced severe hypertriglyceridemia when treated with a pediatric-inspired regimen.

Autor: Al Nabhani I; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Andrews C; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Sibai J; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Atenafu E; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Young T; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Chan SM; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Gupta V; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Maze D; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Schimmer AD; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Schuh AC; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Yee K; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada., Sibai H; Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre University Health Network Toronto Ontario Canada.
Jazyk: angličtina
Zdroj: EJHaem [EJHaem] 2022 Nov 04; Vol. 4 (1), pp. 232-235. Date of Electronic Publication: 2022 Nov 04 (Print Publication: 2023).
DOI: 10.1002/jha2.607
Abstrakt: PEG-asparaginase is used as a treatment for Philadelphia-negative acute lymphoblastic leukemia. In pediatric studies, triglycerides (TGs) were affected more by PEG-asparaginase than by native L-asparaginase (10.0% vs. 5.5%). We conducted a retrospective study to determine the safety of re-challenging adult patients with PEG-asparaginase after experiencing an episode of severe hypertriglyceridemia (>1000 mg/dl or 11.4 mmol/L). The incidence of hypertriglyceridemia associated with PEG-asparaginase in adult patients was high (67.5%). Therefore, checking TGs at baseline and monitoring levels while receiving PEG-asparaginase need to be considered and studied in prospective studies. However, in patients with hypertriglyceridemia not complicated by acute pancreatitis, re-challenging is safe once TG levels normalize.
Competing Interests: The 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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