Medical College of Wisconsin
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Tolerability and Efficacy of a 1-Bag Pegaspargase Densensitization Protocol in Pediatric Oncology Patients. J Pediatr Hematol Oncol 2022 Apr 01;44(3):e623-e627

Date

06/17/2021

Pubmed ID

34133383

DOI

10.1097/MPH.0000000000002241

Scopus ID

2-s2.0-85127925439 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

Desensitization to pegaspargase has been previously attempted in patients who have a hypersensitivity reaction to pegaspargase when Erwinia asparaginase is not an available alternative because of supply issues. Often, these desensitizations have utilized a 3-bag method to complete the infusion. Retrospective chart review was utilized to evaluate the tolerability and efficacy of a 1-bag method for pegaspargase densensitization at a single center. Pegaspargase was infused over ∼3 hours with increases to the infusion rate every 15 minutes. Fifteen pediatric patients received a total of 28 pegaspargase infusions utilizing a 1-bag method. In total, 23 of the infusions were able to be successfully completed without signs of hypersensitivity reactions. In addition, 9 of the 15 patients were able to both successfully complete all infusions during the study period and have asparaginase levels within the therapeutic range 7 to 14 days after the infusion. Four of the 5 patients that did experience a hypersensitivity reaction were able to complete the infusion, however, none of these patients had acceptable asparaginase levels postinfusion. No patient required intubation or advanced life support measures secondary to anaphylaxis. Overall, the pegaspargase method described here was successful and well tolerated in a majority of patients.

Author List

Cramer J, Graff J, Serebin D

Author

Jesse L. Cramer PharmD Adjunct Assistant Professor in the School of Pharmacy Administration department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Anaphylaxis
Antineoplastic Agents
Asparaginase
Child
Drug Hypersensitivity
Humans
Polyethylene Glycols
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Retrospective Studies