Objective: To evaluate the safety of polyethylene glycol conjugated L-asparaginase (PEG-Asp) for patients with adult acute lymphoblastic leukemia (ALL) and T cell non-Hodgkin lymphoma (T-NHL).
Methods: A retrospective analysis was conducted on the clinical data of 101 young patients (≤40 years old) with ALL and T-NHL, diagnosed at Peking Union Medical College Hospital between January 2012 and June 2014.
Results: A total of 480 doses of PEG-Asp were administered in 44 cases with ALL and 57 patients with T-NHL. Only one patient (0.2%) experienced mild allergic reaction. Other grade 3 or 4 toxicities of non-hematologic effects included low level of fibrogen (6.4%), elevated ALT (4.4%), blood glucose (2.3%), and triglyceridemia (2.3%), decreased albumin (0.8%) and elevated amylase (0.2%). Furthermore, 5 cases (1.0%) developed venous thrombosis, 9 cases (1.9%) hemorrage, 1 patient (0.2%) non-necrosis pancretitis.
Conclusion: The risk of allergic reaction incurred by PEG-Asp is very low. It can be used safely in ALL and T-NHL. Coagulation status should be monitored during the treatment.
目的: 观察培门冬酶在中国成人急性淋巴细胞白血病（ALL）与T细胞非霍奇金淋巴瘤（T-NHL）患者治疗中的安全性。
方法: 回顾性分析2012年1月至2014年6月101例接受过基于培门冬酶化疗方案的年轻（≤40岁）成人ALL和T-NHL患者的临床资料和治疗后不良反应。
结果: 101例患者中ALL 44例[中位年龄23（15~40）岁]，T-NHL 57例[中位年龄40（16~77）岁]。101例患者共使用培门冬酶480例次，中位使用次数为3（1~19）次，累计发生3~4级非血液学不良反应80例次（16.7%），包括纤维蛋白原减低（6.4%）、ALT升高（4.4%）、血糖升高（2.3%）、高三酰甘油（TG）血症（2.3%）、低白蛋白血症（0.8%）和淀粉酶升高（0.2%）；仅1例次（0.2%）发生轻度过敏反应；另外，有5例次（1.0%）发生静脉血栓，9例次（1.9%）发生出血，1例次（0.2%）发生非坏死性胰腺炎。
结论: 培门冬酶的过敏反应发生率极低，可安全地用于年轻成人ALL和T-NHL患者的治疗。使用过程中应密切监测患者的出凝血情况。