Clinical Characteristics of Intravenous PEG-Asparaginase Hypersensitivity Reactions in Patients Undergoing Treatment for Acute Lymphoblastic Leukemia. (March 2018)

• Record Type: Journal Article
• Authors: Browne, Emily K.; Moore, Christina; Sykes, April; Lu, Zhaohua; Jeha, Sima; Mandrell, Belinda N.
• Is Part Of: Journal of pediatric oncology nursing. Volume 35:Number 2(2018:Mar./Apr.)
• Page Start: 103
• Page End: 109
• Publication Date: 2018-03
• Subjects: PEG-asparaginase -- hypersensitivity -- reaction -- allergy -- nursing; Cancer in children -- Periodicals; Pediatric nursing -- Periodicals; 618.92994
• DOI: 10.1177/1043454217741868
• Languages: English
• ISSNs: 1043-4542

Abstract

Background: Asparaginase poses a substantial risk for hypersensitivity reactions during and after administration; however, these reactions vary by asparaginase formulation and administration route. It is imperative that nurses be knowledgeable of clinical symptoms associated with intravenous (IV) monomethoxypolyethylene glycol (PEG)-asparaginase reactions, as well as potential reaction timing.Purpose: This single institution retrospective study describes the clinical factors among patients with IV PEG-asparaginase hypersensitivity reactions.Methods: Reaction frequency and severity, dose, phase of treatment, and time between infusion initiation and reaction were collected on patients identified as having an IV PEG-asparaginase hypersensitivity reaction while undergoing acute lymphoblastic leukemia treatment.Results: Sixty-three patients (12.8%) developed a hypersensitivity reaction to IV PEG-asparaginase, with the reaction occurring during a median of 3 doses in both risk arms. Reactions were noted ≤60 minutes after infusion initiation in 98% of patients, and no reactions were fatal.Conclusion: Nurses should carefully observe patients throughout the infusion and anticipate adverse reactions, particularly during the first 3 doses and first 10 minutes of each infusion. Patient and family education should include the rare risk of delayed reactions.