How to manage asparaginase hypersensitivity in acute lymphoblastic leukemia. Future Oncol 2014 Dec;10(16):2615-27
Date
07/02/2014Pubmed ID
24983955DOI
10.2217/fon.14.138Scopus ID
2-s2.0-84919791996 (requires institutional sign-in at Scopus site) 42 CitationsAbstract
Outcomes for children with acute lymphoblastic leukemia (ALL) have improved significantly in recent decades, primarily due to dose-intensified, multi-agent chemotherapy regimens, of which asparaginase has played a prominent role. Despite this success, hypersensitivity remains a significant problem, often requiring the termination of asparaginase. Failure to complete the entire asparaginase therapy course due to clinical hypersensitivity, subclinical hypersensitivity (i.e., silent inactivation), or other treatment-related toxicity is associated with poor ALL outcomes. Thus, it is critical to rapidly identify patients who develop clinical/subclinical hypersensitivity and switch these patients to an alternate asparaginase formulation. This article provides an overview of asparaginase hypersensitivity, identification and management of hypersensitivity and subclinical hypersensitivity, and issues related to switching patients to asparaginase Erwinia chrysanthemi following hypersensitivity reaction.
Author List
Burke MJAuthor
Michael James Burke MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Antineoplastic AgentsAsparaginase
Chemistry, Pharmaceutical
Child
Humans
Hypersensitivity
Precursor Cell Lymphoblastic Leukemia-Lymphoma