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Posted by on Mar 27, 2020 in Leukemia | 0 comments

In a nutshell

This study aimed to investigate the activity of two types of asparaginase drugs in pediatric patients with acute lymphoblastic leukemia or non-Hodgkin lymphoma. This study concluded that this type of treatment needs close monitoring for optimal effectiveness.

Some background

Asparaginase (ASNase) is a drug used in the treatment of childhood acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL). Many patients develop a reaction to ASNase which leads to the clearance and inactivation of the drug in the body. This reaction can lead to allergic reactions or silent inactivation (SI).  

Two types of ASNase that can be used to treat children with ALL and NHL. These are pegylated Escherichia coli (PEG-)ASNase and Erwinia ASNase. A low ASNase activity has been associated with a higher risk of relapse. It was unknown if the activity of PEG-ASNase and Erwinia ASNase could be monitored for a better activity in patients with ALL and NHL.  

Methods & findings

This study involved 286 patients aged 18 and under with ALL and NHL. 286 patients were treated with PEG-ASNase. Of this group, 11.2% of patients experienced allergy and 5.2% experienced SI. Patients received Erwinia ASNase as second-line treatment after allergic reactions to PEG-ASNase. 42 patients were treated with Erwinia ASNase. Of this group, 7.1% experienced allergy and 2.4% experienced SI.  

The activity of PEG-ASNase was high in all patients without an allergic reaction. After Erwinia treatment, 62.5% of day 3 samples had decreased activity compared to 10% of day 2 samples. The average day 2 activity was higher for intramuscular (IM) treatment than for intravenous (IV) Erwinia treatment. 

The bottom line

This study concluded that the activity of ASNase therapy in children with ALL or NHL needs close monitoring for optimal effectiveness. 

Published By :

British Journal of Haematology

Date :

Feb 14, 2020

Original Title :

Prospective, real-time monitoring of pegylated Escherichia coli and Erwinia asparaginase therapy in childhood acute lymphoblastic leukaemia and non-Hodgkin lymphoma in Belgium.

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