Home Neoplasma 2018 Neoplasma Vol.65, No.6, p.993-997, 2018

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Neoplasma Vol.65, No.6, p.993-997, 2018

Title: Safety profile of a single pegylated asparaginase (PEG-ASP) dose in remission induction for acute lymphoblastic leukemia (ALL)
Author: G. HELBIG, A. ARMATYS, K. BORAL, A.J. KOPINSKA, K. WOZNICZKA, M. DWORACZEK, K. CHROMIK, A. KOCLEGA, M. PANZ-KLAPUCH, M. WYSOCKA, A. JANIKOWSKA

Abstract: The incorporation of pegylated asparaginase (PEG-ASP) in pediatric and adult acute lymphoblastic leukemia (ALL) protocols remains a worldwide therapeutic approach. However the safety profile remains a challenge, and herein we report the toxicity of an intravenous single dose of 1000 IU/m2 PEG-ASP administered in remission induction for adult ALL patients. Thirty-two patients at median diagnostic age of 32 years (median of 19-65) were included in this analysis. Most patients had B-cell lymphoblastic leukemia (n=26; 78%) and 81% of cases were tration to first toxic symptoms was 7 days (range 1-19), and there were also 4 (13%) early induction deaths. All deaths were observed in ≥50-year-old patients after a median of 5 days following PEG-ASP (range 1-9). Three of these four patients had massive obesity. While all expired patients had grade 4 neutropenia and thrombocytopenia at the time of death, sepsis was not present. Administration of PEG-ASP in induction remission for ALL patients resulted in a significant, but mostly reversible hepatotoxicity. This PEG-ASP treatment should be administered with caution for older, obese patients.

Keywords: acute lymphoblastic leukemia, asparaginase, pegylated asparaginase, toxicity, induction, remission
Published online: 18-Jun-2018
Year: 2018, Volume: 65, Issue: 6 Page From: 993, Page To: 997
doi:10.4149/neo_2018_180214N121
Price: 10.50 €






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