Hsiu-Ju Yen1,2, Wan-Hui Chang3, Hsi-Che Liu4, Ting-Chi Yeh4, Giun-Yi Hung1,2, Kang-Hsi Wu5, Ching-Tien Peng5, Yu-Hsiang Chang6, Te-Kao Chang7, Chih-Cheng Hsiao8, Jiunn-Ming Sheen8, Yu-Hua Chao9, Tai-Tsung Chang10, Shyh-Shin Chiou10, Pei-Chin Lin10, Shih-Chung Wang11, Ming-Tsan Lin11, Wan-Ling Ho12,13, Yu-Chieh Chen8, Der-Cherng Liang4. 1. Department of Pediatrics, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan. 2. Department of Life Science, National Taiwan Normal University, Taipei, Taiwan. 3. Biostatistical Center, Childhood Cancer Foundation, Taipei, Taiwan. 4. Department of Pediatrics, Mackay Memorial Hospital, and Mackay Medical College, Taipei, Taiwan. 5. Department of Pediatric Hemato/Oncology, Children's Hospital of China Medical University, Taichung, Taiwan. 6. Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. 7. Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan. 8. Department of Pediatrics, Chang Gung Children's Hospital-Kaohsiung, Kaohsiung, Taiwan. 9. Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan. 10. Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 11. Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan. 12. Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. 13. School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Abstract
BACKGROUND: Discontinuation of E. coli l-asparaginase in patients with acute lymphoblastic leukemia (ALL) is unavoidable upon severe allergic reaction. We sought to examine outcomes following E. coli l-asparaginase discontinuation due to severe allergic reactions. PROCEDURE: We evaluated the outcome of children enrolled in Taiwan Pediatric Oncology Group-2002-ALL protocol between 2002 and 2012, who had E. coli l-asparaginase discontinued due to severe allergic reactions, and compared the outcomes of those who continued with Erwinia l-asparaginase (Erwinase) with those who did not. RESULTS: Among 700 patients enrolled in this study, 33 patients had E. coli l-asparaginase treatment discontinued due to severe allergic reactions. Five-year overall survival did not differ significantly among the 648 patients without discontinuation (81 ± 1.6%, mean ± SE), compared to 17 patients with allergic reactions and treated with Erwinase (88 ± 7.8%) and 16 patients with allergic reactions but not treated with Erwinase (87 ± 8.6%). Among 16 patients who did not receive Erwinase, all 10 who received ≥50% of the scheduled doses of E. coli l-asparaginase before discontinuation survived without events. CONCLUSIONS: Erwinase treatment may not be needed for some ALL patients with severe allergy to E. coli l-asparaginase if ≥50% of prescribed doses were received and/or therapy is augmented with other agents.
BACKGROUND: Discontinuation of E. coli l-asparaginase in patients with acute lymphoblastic leukemia (ALL) is unavoidable upon severe allergic reaction. We sought to examine outcomes following E. coli l-asparaginase discontinuation due to severe allergic reactions. PROCEDURE: We evaluated the outcome of children enrolled in Taiwan Pediatric Oncology Group-2002-ALL protocol between 2002 and 2012, who had E. coli l-asparaginase discontinued due to severe allergic reactions, and compared the outcomes of those who continued with Erwinia l-asparaginase (Erwinase) with those who did not. RESULTS: Among 700 patients enrolled in this study, 33 patients had E. coli l-asparaginase treatment discontinued due to severe allergic reactions. Five-year overall survival did not differ significantly among the 648 patients without discontinuation (81 ± 1.6%, mean ± SE), compared to 17 patients with allergic reactions and treated with Erwinase (88 ± 7.8%) and 16 patients with allergic reactions but not treated with Erwinase (87 ± 8.6%). Among 16 patients who did not receive Erwinase, all 10 who received ≥50% of the scheduled doses of E. coli l-asparaginase before discontinuation survived without events. CONCLUSIONS: Erwinase treatment may not be needed for some ALL patients with severe allergy to E. coli l-asparaginase if ≥50% of prescribed doses were received and/or therapy is augmented with other agents.
Authors: Sumit Gupta; Cindy Wang; Elizabeth A Raetz; Reuven Schore; Wanda L Salzer; Eric C Larsen; Kelly W Maloney; Len A Mattano; William L Carroll; Naomi J Winick; Stephen P Hunger; Mignon L Loh; Meenakshi Devidas Journal: J Clin Oncol Date: 2020-04-10 Impact factor: 44.544
Authors: Gabriela Galindo-Rodríguez; José C Jaime-Pérez; Mario C Salinas-Carmona; Sandra N González-Díaz; Ángeles Castro-Corona; Raúl Cavazos-González; Humberto Treviño-Villarreal; Alberto C Heredia-Salazar; David Gómez-Almaguer Journal: Rev Bras Hematol Hemoter Date: 2017-01-24
Authors: Maaike Van Trimpont; Evelien Peeters; Yanti De Visser; Amanda M Schalk; Veerle Mondelaers; Barbara De Moerloose; Arnon Lavie; Tim Lammens; Steven Goossens; Pieter Van Vlierberghe Journal: Cancers (Basel) Date: 2022-02-11 Impact factor: 6.639