Pegaspargase Re-Challenge After Grade 2 Hypersensitivity Reaction In Childhood Acute Lymphoblastic Leukemia: Results From Dfci 16-001
BLOOD(2020)
摘要
Introduction: Hypersensitivity reactions with asparaginase occur frequently in pediatric patients (pts) with acute lymphoblastic leukemia (ALL). The standard approach for pts with reaction to E.coli-derived asparaginase is to switch to Erwinia asparaginase, given concern that clinical reactions reflect presence of neutralizing antibodies; however, Erwinia requires more frequent dosing and is often unavailable. Therapeutic drug monitoring allows for discrimination between pts with pegaspargase hypersensitivity who have sub-therapeutic asparaginase activity and those still able to derive therapeutic benefit from pegaspargase. We prospectively piloted re-challenging pts with pegaspargase after initial Grade 2 hypersensitivity to this agent, with premedication at re-challenge and assessment of serum asparaginase activity (SAA).
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关键词
childhood acute lymphoblastic leukemia,acute lymphoblastic leukemia,hypersensitivity reaction,re-challenge
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