Outcomes Following Discontinuation of E. colil‐Asparaginase Upon Severe Allergic Reactions in Children With Acute Lymphoblastic Leukemia. Issue 4 (24th December 2015)

• Record Type: Journal Article
• Authors: Yen, Hsiu‐Ju; Chang, Wan‐Hui; Liu, Hsi‐Che; Yeh, Ting‐Chi; Hung, Giun‐Yi; Wu, Kang‐Hsi; Peng, Ching‐Tien; Chang, Yu‐Hsiang; Chang, Te‐Kao; Hsiao, Chih‐Cheng; Sheen, Jiunn‐Ming; Chao, Yu‐Hua; Chang, Tai‐Tsung; Chiou, Shyh‐Shin; Lin, Pei‐Chin; Wang, Shih‐Chung; Lin, Ming‐Tsan; Ho, Wan‐Ling; Chen, Yu‐Chieh; Liang, Der‐Cherng
• Is Part Of: Pediatric blood & cancer. Volume 63:Issue 4(2016)
• Page Start: 665
• Page End: 670
• Publication Date: 2015-12-24
• Subjects: acute lymphoblastic leukemia -- children -- E. colil‐asparaginase -- discontinuation -- outcome -- severe allergy; Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.25869
• Languages: English
• ISSNs: 1545-5009

Abstract

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 Erwinial ‐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.