Lower incidence of clinical allergy with PEG‐asparaginase upfront versus the sequential use of native E. coli asparaginase followed by PEG‐ASP in pediatric patients with acute lymphoblastic leukemia
| Autor: | Anna Ruiz-Llobet, Ariadna Comes-Escoda, Edgar Zapico-Muñiz, Mireia Camós, Anna Faura, Susana Rives, Nuria Conde, J.L. Dapena, Sara Perez-Jaume, Montserrat Mesegué, Anna Alonso-Saladrigues, Albert Català |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Allergy Asparaginase Adolescent Gastroenterology Polyethylene Glycols Young Adult chemistry.chemical_compound Internal medicine PEG ratio Escherichia coli Hypersensitivity medicine Humans Cumulative incidence Child medicine.diagnostic_test business.industry Incidence Immunogenicity Incidence (epidemiology) Infant Hematology General Medicine Precursor Cell Lymphoblastic Leukemia-Lymphoma Prognosis medicine.disease Oncology chemistry Spain Therapeutic drug monitoring Child Preschool Toxicity Female business Follow-Up Studies |
| Zdroj: | Hematological Oncology. 39:687-696 |
| ISSN: | 1099-1069 0278-0232 |
| Popis: | Asparaginase (ASP) is an essential component for the acute lymphoblastic leukemia (ALL) treatment, but toxicities, such as allergy, frequently limit its use. Although the potentially lower PEG-ASP formulation immunogenicity, few studies with conflicting results have compared the allergy incidence between Escherichia coli-ASP and PEG-ASP in the same protocol. We aimed at comparing the allergy incidence in children receiving native E. coli-ASP versus PEG-ASP within the same clinical protocol (Spanish Society of Pediatric Hematology and Oncology ALL-SEHOP-PETHEMA 2013). One hundred and twenty-six children (1-19 years) diagnosed with ALL from 2013 to 2020 were included. Patients in group 1 received a sequential scheme of native E. coli-ASP 10,000 IU/m2 intramuscularly (IM) followed by PEG-ASP 1000 IU/m2 IM. Patients in group 2 received PEG-ASP 1000 IU/m2 IM upfront. Clinical allergy incidence was compared between both groups. Serum ASP activity (SAA) was measured in a subgroup of patients, and silent inactivation was recorded. The cumulative incidence of clinical allergy was significantly higher in group 1 (native followed by PEG-ASP) than in group 2 (PEG-ASP upfront), 24.7% versus 4.1% (p = 0.0085). Adequate ASP activity was achieved with PEG-ASP 1000 IU/m2 dose in most patients (median SAA 412.5 and 453.0 IU/L at days 7 and 14). The incidence of silent inactivation in PEG-ASP upfront patients was very low. PEG-ASP-used upfront was associated with a lower incidence of clinical allergy than that observed in the sequential use of native E. coli-ASP followed by PEG-ASP. PEG-ASP at 1000 IU/m2 was effective in achieving enough ASP activity in most patients. |
| Databáze: | OpenAIRE |
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