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neo_2018_180214N121

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) into pediatric and adult acute lymphoblastic leukemia (ALL) protocols remains a worldwide therapeutic standard, however the safety profile is a challenge. We herein report, in adults, the toxicity of intravenous single dose of 1000 IU/m2 PEG-ASP administered in remission induction for ALL patients. Thirty two patients at median age at diagnosis of 32 years (median 19-65) were included in this analysis. Most patients had B-cell lymphoblastic leukemia (n=26; 78%) and 81% of cases were dministration to first toxic symptoms was 7 days (range 1-19). There were 4 (13%) early induction deaths among those receiving PEG-ASP. All deaths were observed in patients ≥50 years after median of 5 days after PEG-ASP (range 1-9). Three out of 4 patients had massive obesity. All expired patients had grade 4 neutropenia and thrombocytopenia at the time of death, however sepsis was not present. Administration of PEG-ASP in induction remission for ALL patients resulted in a significant, but mostly reversible hepatotoxicity. This treatment should be administered in caution for older, obese patients.

Keywords: acute lymphoblastic leukemia, asparaginase, pegylated asparaginase, toxicity, induction, remission
Published online: 18-Jun-2018
Year: , Volume: , Issue: Page From: , Page To:
doi:10.4149/neo_2018_180214N121


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