{"title":"急性淋巴细胞白血病患儿l -天冬酰胺酶治疗的监测，重点关注沉默失活及其对治疗结果的影响","authors":"Malgorzata Czogala, Iwona Rogatko, Katarzyna Pawińska-Wąsikowska, Wojciech Czogała, Wioletta Bal, Małgorzata Ciebiera, Radosław Chaber, Agnieszka Chodała-Grzywacz, Grażyna Karolczyk, Krystyna Sztefko, Walentyna Balwierz, Szymon Skoczeń","doi":"10.5114/wo.2023.124972","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to analyse the frequency of silent inactivation and allergic reaction to asparaginase (ASP) and its impact on treatment results in patients with lymphoblastic leukaemia.</p><p><strong>Material and methods: </strong>Seventy patients with acute lymphoblastic leukaemia treated with ASP were enrolled in the study. Asparaginase activity was monitored. The patients were switched to another ASP formulation after allergy or inactivation. The treatment results were analysed.</p><p><strong>Results: </strong>Silent inactivation of native <i>E. coli</i> ASP was diagnosed in 5 patients (7%) and allergy in 34 patients (49%), and these patients were switched to pegylated ASP (PEG-ASP). Silent inactivation of PEG-ASP occurred in 8 patients (23%) and allergy in 6 patients (17%). Eight children continued therapy with Erwinase, and 4 did not switch to Erwinase after inactivation of PEG-ASP. Allergy to Erwinase occurred in 2 patients (22%); there was no inactivation. No significant differences in outcome were found between the groups of patients with and without allergy or silent inactivation of ASP. Due to regular monitoring and switching to other ASP preparations after allergy or silent inactivation, therapeutic activity was ensured in almost all patients.</p><p><strong>Conclusions: </strong>Monitoring of ASP activity is crucial to recognize silent inactivation and to guarantee treatment effectiveness by switching to other ASP preparations.</p>","PeriodicalId":49354,"journal":{"name":"Wspolczesna Onkologia-Contemporary Oncology","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/6b/WO-26-50127.PMC9933359.pdf","citationCount":"0","resultStr":"{\"title\":\"Monitoring of treatment with L-asparaginase in children with acute lymphoblastic leukaemia, with a focus on silent inactivation and its influence on the treatment outcome.\",\"authors\":\"Malgorzata Czogala, Iwona Rogatko, Katarzyna Pawińska-Wąsikowska, Wojciech Czogała, Wioletta Bal, Małgorzata Ciebiera, Radosław Chaber, Agnieszka Chodała-Grzywacz, Grażyna Karolczyk, Krystyna Sztefko, Walentyna Balwierz, Szymon Skoczeń\",\"doi\":\"10.5114/wo.2023.124972\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The aim of the study was to analyse the frequency of silent inactivation and allergic reaction to asparaginase (ASP) and its impact on treatment results in patients with lymphoblastic leukaemia.</p><p><strong>Material and methods: </strong>Seventy patients with acute lymphoblastic leukaemia treated with ASP were enrolled in the study. Asparaginase activity was monitored. The patients were switched to another ASP formulation after allergy or inactivation. The treatment results were analysed.</p><p><strong>Results: </strong>Silent inactivation of native <i>E. coli</i> ASP was diagnosed in 5 patients (7%) and allergy in 34 patients (49%), and these patients were switched to pegylated ASP (PEG-ASP). Silent inactivation of PEG-ASP occurred in 8 patients (23%) and allergy in 6 patients (17%). Eight children continued therapy with Erwinase, and 4 did not switch to Erwinase after inactivation of PEG-ASP. Allergy to Erwinase occurred in 2 patients (22%); there was no inactivation. No significant differences in outcome were found between the groups of patients with and without allergy or silent inactivation of ASP. Due to regular monitoring and switching to other ASP preparations after allergy or silent inactivation, therapeutic activity was ensured in almost all patients.</p><p><strong>Conclusions: </strong>Monitoring of ASP activity is crucial to recognize silent inactivation and to guarantee treatment effectiveness by switching to other ASP preparations.</p>\",\"PeriodicalId\":49354,\"journal\":{\"name\":\"Wspolczesna Onkologia-Contemporary Oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/6b/WO-26-50127.PMC9933359.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Wspolczesna Onkologia-Contemporary Oncology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5114/wo.2023.124972\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wspolczesna Onkologia-Contemporary Oncology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5114/wo.2023.124972","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Monitoring of treatment with L-asparaginase in children with acute lymphoblastic leukaemia, with a focus on silent inactivation and its influence on the treatment outcome.
Introduction: The aim of the study was to analyse the frequency of silent inactivation and allergic reaction to asparaginase (ASP) and its impact on treatment results in patients with lymphoblastic leukaemia.
Material and methods: Seventy patients with acute lymphoblastic leukaemia treated with ASP were enrolled in the study. Asparaginase activity was monitored. The patients were switched to another ASP formulation after allergy or inactivation. The treatment results were analysed.
Results: Silent inactivation of native E. coli ASP was diagnosed in 5 patients (7%) and allergy in 34 patients (49%), and these patients were switched to pegylated ASP (PEG-ASP). Silent inactivation of PEG-ASP occurred in 8 patients (23%) and allergy in 6 patients (17%). Eight children continued therapy with Erwinase, and 4 did not switch to Erwinase after inactivation of PEG-ASP. Allergy to Erwinase occurred in 2 patients (22%); there was no inactivation. No significant differences in outcome were found between the groups of patients with and without allergy or silent inactivation of ASP. Due to regular monitoring and switching to other ASP preparations after allergy or silent inactivation, therapeutic activity was ensured in almost all patients.
Conclusions: Monitoring of ASP activity is crucial to recognize silent inactivation and to guarantee treatment effectiveness by switching to other ASP preparations.
期刊介绍：
Contemporary Oncology is a journal aimed at oncologists, oncological surgeons, hematologists, radiologists, pathologists, radiotherapists, palliative care specialists, psychologists, nutritionists, and representatives of any other professions, whose interests are related to cancer. Manuscripts devoted to basic research in the field of oncology are also welcomed.
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