Desensitization to pegaspargase in children with acute lymphoblastic leukemia and lymphoblastic lymphoma

Pediatr Blood Cancer. 2020 Jan;67(1):e28021. doi: 10.1002/pbc.28021. Epub 2019 Oct 1.

Abstract

Hypersensitivity to pegaspargase is associated with inferior survival in pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma. In the past year, drug-supply shortages have led to the lack of an available alternative to pegaspargase. Rather than omit asparaginase from the treatment of acute lymphoblastic leukemia or lymphoblastic lymphoma patients with hypersensitivity to pegaspargase, we continued pegaspargase treatments for nine pediatric patients, utilizing a rapid desensitization protocol. There were no adverse events related to the pegaspargase during desensitization, and all patients who were checked had asparaginase serum levels above the threshold of 0.1 IU/mL at 7 to 14 days after pegaspargase therapy.

Keywords: acute lymphoblastic leukemia; asparaginase; children; lymphoblastic lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Agents / therapeutic use*
  • Asparaginase / therapeutic use*
  • Desensitization, Immunologic / methods*
  • Humans
  • Lymphoma, T-Cell / drug therapy*
  • Lymphoma, T-Cell / immunology
  • Lymphoma, T-Cell / pathology
  • Male
  • Polyethylene Glycols / therapeutic use*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Prognosis

Substances

  • Antineoplastic Agents
  • Polyethylene Glycols
  • pegaspargase
  • Asparaginase