dc.contributor.author | López López, Elixabet | |
dc.contributor.author | Ponte di Legno Toxicity Working Group | |
dc.date.accessioned | 2022-01-17T09:28:42Z | |
dc.date.available | 2022-01-17T09:28:42Z | |
dc.date.issued | 2022-02 | |
dc.identifier.citation | European Journal of Cancer 162 : 65-75 (2022) | es_ES |
dc.identifier.issn | 1879-0852 | |
dc.identifier.uri | http://hdl.handle.net/10810/55013 | |
dc.description.abstract | [EN] BACKGROUND: Hypersensitivity reactions to asparaginase challenge its use and occur frequently (30-75%) after native Escherichia Coli (E.coli) asparaginase. Comparison of incidence of allergic reactions to pegylated E.coli asparaginase (PEGasparaginase) across contemporary paediatric acute lymphoblastic leukaemia (ALL) protocols is lacking.
METHOD AND PATIENTS: Questionnaires were sent to all members of the international ALL Ponte di Legno Toxicity Working Group. Meta-analyses were conducted to estimate the incidence of three types of hypersensitivity (allergy, allergic-like reaction and silent inactivation). Information on protocol level regarding PEGasparaginase dosing regimen, administration route and use of therapeutic drug monitoring was collected for risk analysis.
RESULTS: Newly diagnosedpatients with ALL (n=5880), aged 1-24 years old, were enrolled in seven different upfront ALL protocols using PEGasparaginase as first-line treatment. The incidence of allergic reactions (sum of allergies and allergic-like reactions) [95% confidence interval] was 2% [1%; 3%] during induction and 8% [5%; 11%] during postinduction. Route of administration, number of doses, dosage and number of PEGasparaginase-free weeks did not significantly influence risk of hypersensitivity. Multivariate meta-regression analysis suggests that initiation of PEGasparaginase in postinduction and higher number of PEGasparaginase-free intervals increased the risk for allergic reactions. 9-16% and 23-29% of all hypersensitivities were allergic-like reactions and silent inactivation, respectively.
CONCLUSION: The incidence of allergic reactions is lower in protocols using PEGasparaginase as first-line treatment compared with that reported for E.coli asparaginase or PEGasparaginase after E.coli asparaginase. Postinduction phase, a higher number of PEGasparaginase-free intervals, and initiation of PEGasparaginase in postinduction phase are risk factors for allergic reactions. These results are important for planning of PEGasparaginase administrations in future frontline therapy. | es_ES |
dc.description.sponsorship | BSPHO: none.
CoALL: none.
DCOG: none.
DFCI: none.
NOPHO: The authors BKA and KS would like to thank the Danish Cancer Society and the Danish Childhood Cancer Society for supporting this study.
LAL/SEHOP-PETHEMA: Author ELL would like to thank all involved hospitals for data collection.
UKALL: Author AV would like to thank Amy Kirkwood, UKALL 2011 statistician, for collecting the UK data. | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Elsevier | es_ES |
dc.rights | info:eu-repo/semantics/openAccess | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/es/ | * |
dc.subject | acute lymphoblastic leukaemia | es_ES |
dc.subject | paediatric ALL | es_ES |
dc.subject | PEGasparaginase | es_ES |
dc.subject | hypersensitivity | es_ES |
dc.subject | risk factors | es_ES |
dc.title | Hypersensitivity to Pegylated E.coli asparaginase as first-line treatment in contemporary paediatric acute lymphoblastic leukaemia protocols: a meta-analysis of the Ponte di Legno Toxicity working group | es_ES |
dc.type | info:eu-repo/semantics/article | es_ES |
dc.rights.holder | © 2021 The Author(s). This is an open access article under the CC BY-NC-ND license | es_ES |
dc.rights.holder | Atribución-NoComercial-SinDerivadas 3.0 España | * |
dc.relation.publisherversion | https://www.sciencedirect.com/science/article/pii/S0959804921012260?via%3Dihub | es_ES |
dc.identifier.doi | 10.1016/j.ejca.2021.11.016 | |
dc.departamentoes | Bioquímica y biología molecular | es_ES |
dc.departamentoeu | Biokimika eta biologia molekularra | es_ES |