Asparaginase-Associated Pancreatitis in Acute Lymphoblastic Leukemia: Results From the NOPHO ALL2008 Treatment of Patients 1-45 Years of Age
| Autor: | Laimonas Griskevicius, Thomas Frandsen, Bendik Lund, Peder Skov Wehner, Ulrik Malthe Overgaard, Mats Heyman, Kathrine Grell, Jonas Abrahamsson, Ove Juul Nielsen, Olafur Gisli Jonsson, Nina Toft, Birgitte Klug Albertsen, Mari Punab, Beata Tomaszewska-Toporska, Kristi Lepik, Ulrika Norén-Nyström, Petter Quist-Paulsen, Kjeld Schmiegelow, Goda Vaitkevičienė, Arja Harila-Saari, Mervi Taskinen, Benjamin Ole Wolthers, Cecilie Utke Rank, Johan Malmros, Ulla Wartiovaara-Kautto, Kirsten Brunsvig Jarvis |
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| Přispěvatelé: | HUS Comprehensive Cancer Center, HUS Children and Adolescents, Lastentautien yksikkö, Children's Hospital, Department of Oncology |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
PROTOCOL
Male Cancer Research Lymphoblastic Leukemia CHILDREN Gastroenterology Pediatrics Polyethylene Glycols DEFINITIONS chemistry.chemical_compound 0302 clinical medicine Standard Risk YOUNG-ADULTS ADOLESCENTS Young adult acute lymphoblastic leukemia pancreatitis asparaginase Child Randomized Controlled Trials as Topic Incidence (epidemiology) Incidence Pediatrik ORIGINAL REPORTS Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma FARBER-CANCER-INSTITUTE 3. Good health Oncology 030220 oncology & carcinogenesis Child Preschool Female Adult Estonia medicine.medical_specialty Asparaginase COLI L-ASPARAGINASE Adolescent 3122 Cancers Antineoplastic Agents Scandinavian and Nordic Countries STANDARD-RISK CLASSIFICATION 03 medical and health sciences Young Adult Age groups Internal medicine medicine Hematologic Malignancy Humans In patient ERWINIA-ASPARAGINASE business.industry Infant Lithuania medicine.disease chemistry Pancreatitis business 030215 immunology |
| Zdroj: | Journal of Clinical Oncology Rank, C U, Wolthers, B O, Grell, K, Albertsen, B K, Frandsen, T L, Overgaard, U M, Toft, N, Nielsen, O J, Wehner, P S, Harila-Saari, A, Heyman, M M, Malmros, J, Abrahamsson, J, Norén-Nyström, U, Tomaszewska-Toporska, B, Lund, B, Jarvis, K B, Quist-Paulsen, P, Vaitkevičienė, G E, Griškevičius, L, Taskinen, M, Wartiovaara-Kautto, U, Lepik, K, Punab, M, Jónsson, Ó G & Schmiegelow, K 2020, ' Asparaginase-Associated Pancreatitis in Acute Lymphoblastic Leukemia : Results From the NOPHO ALL2008 Treatment of Patients 1-45 Years of Age ', Journal of Clinical Oncology, vol. 38, no. 2, pp. 145-154 . https://doi.org/10.1200/JCO.19.02208 Journal of clinical oncology, Alexandria, VA : American Society of Clinical Oncology, 2020, vol. 38, no. 2, p. 145-154 Rank, C U, Wolthers, B O, Grell, K, Albertsen, B K, Frandsen, T L, Overgaard, U M, Toft, N, Nielsen, O J, Wehner, P S, Harila-Saari, A, Heyman, M M, Malmros, J, Abrahamsson, J, Norén-Nyström, U, Tomaszewska-Toporska, B, Lund, B, Jarvis, K B, Quist-Paulsen, P, Vaitkevičiene, G E, Griškevičius, L, Taskinen, M, Wartiovaara-Kautto, U, Lepik, K, Punab, M, Jónsson, Ó G & Schmiegelow, K 2020, ' Asparaginase-associated pancreatitis in acute lymphoblastic leukemia : Results from the NOPHO ALL2008 treatment of patients 1-45 years of age ', Journal of Clinical Oncology, vol. 38, no. 2, pp. 145-154 . https://doi.org/10.1200/JCO.19.02208 Rank, C U, Wolthers, B O, Grell, K, Albertsen, B K, Frandsen, T L, Overgaard, U M, Toft, N, Nielsen, O J, Wehner, P S, Harila-Saari, A, Heyman, M M, Malmros, J, Abrahamsson, J, Norén-Nyström, U, Tomaszewska-Toporska, B, Lund, B, Jarvis, K B, Quist-Paulsen, P, Vaitkevičienė, G E, Griškevičius, L, Taskinen, M, Wartiovaara-Kautto, U, Lepik, K, Punab, M, Jónsson, Ó G & Schmiegelow, K 2020, ' Asparaginase-Associated Pancreatitis in Acute Lymphoblastic Leukemia : Results From the NOPHO ALL2008 Treatment of Patients 1-45 Years of Age ', Journal of Clinical Oncology, vol. 38, no. 2, pp. 145-155 . https://doi.org/10.1200/JCO.19.02208 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/JCO.19.02208 |
| Popis: | PURPOSE Asparaginase-associated pancreatitis (AAP) is common in patients with acute lymphoblastic leukemia (ALL), but risk differences across age groups both in relation to first-time AAP and after asparaginase re-exposure have not been explored. PATIENTS AND METHODS We prospectively registered AAP (n = 168) during treatment of 2,448 consecutive ALL patients aged 1.0-45.9 years diagnosed from July 2008 to October 2018 and treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol. RESULTS Compared with patients aged 1.0-9.9 years, adjusted AAP hazard ratios (HRa) were associated with higher age with almost identical HRa (1.6; 95% CI, 1.1 to 2.3; P = .02) for adolescents (10.0-17.9 years) and adults (18.0-45.9 years). The day 280 cumulative incidences of AAP were 7.0% for children (1.0-9.9 years: 95% CI, 5.4 to 8.6), 10.1% for adolescents (10.0 to 17.9 years: 95% CI, 7.0 to 13.3), and 11.0% for adults (18.0-45.9 years: 95% CI, 7.1 to 14.9; P = .03). Adolescents had increased odds of both acute (odds ratio [OR], 5.2; 95% CI, 2.1 to 13.2; P = .0005) and persisting complications (OR, 6.7; 95% CI, 2.4 to 18.4; P = .0002) compared with children (1.0-9.9 years), whereas adults had increased odds of only persisting complications (OR, 4.1; 95% CI, 1.4 to 11.8; P = .01). Fifteen of 34 asparaginase-rechallenged patients developed a second AAP. Asparaginase was truncated in 17/21 patients with AAP who subsequently developed leukemic relapse, but neither AAP nor the asparaginase truncation was associated with increased risk of relapse. CONCLUSION Older children and adults had similar AAP risk, whereas morbidity was most pronounced among adolescents. Asparaginase re-exposure should be considered only for patients with an anticipated high risk of leukemic relapse, because multiple studies strongly indicate that reduction of asparaginase treatment intensity increases the risk of relapse. |
| Databáze: | OpenAIRE |
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