Outcomes Following Discontinuation of E. coli l-Asparaginase Upon Severe Allergic Reactions in Children With Acute Lymphoblastic Leukemia

Hsiu Ju Yen, Wan Hui Chang, Hsi Che Liu, Ting Chi Yeh, Giun Yi Hung, Kang Hsi Wu, Ching Tien Peng, Yu Hsiang Chang, Te Kao Chang, Chih Cheng Hsiao, Jiunn Ming Sheen, Yu Hua Chao, Tai Tsung Chang, Shyh Shin Chiou, Pei Chin Lin, Shih Chung Wang, Ming Tsan Lin, Wan Ling Ho, Yu Chieh Chen, Der Cherng Liang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

13 Scopus citations

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 Erwinia l-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.

Original languageEnglish
Pages (from-to)665-670
Number of pages6
JournalPediatric Blood and Cancer
Volume63
Issue number4
DOIs
StatePublished - 01 04 2016

Bibliographical note

Publisher Copyright:
© 2016 Wiley Periodicals, Inc.

Keywords

  • Acute lymphoblastic leukemia
  • Children
  • Discontinuation
  • E. coli l-asparaginase
  • Outcome
  • Severe allergy

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