Managing toxicities with asparaginase-based therapies in adult ALL: summary of an ESMO Open–Cancer Horizons roundtable discussion

ESMO Open

article

Patrick W. Burke¹  Dieter Hoelzer²  Jae H. Park³  Kjeld Schmiegelow⁴  Dan Douer⁵ 

[1] Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan;Internal Medicine;Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center;Department of Pediatrics and Adolescent Medicine, Juliane Marie Center, Rigshospitalet University Hospital, and Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen;Jane Anne Nohle Division of Hematology, University of Southern California

关键词: asparaginase;    acute lymphoblastic leukaemia;    toxicities;    hypersensitivity;    therapeutic drug monitoring;    pancreatitis;    thrombosis;   

DOI  :  10.1136/esmoopen-2020-000858

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

With recent prospective clinical trials that used paediatric regimens with multiple doses of pegylated form of asparaginase (PEG asparaginase) in adults reporting significantly improved survival compared with historical data with regimens that used less asparaginase, PEG asparaginase is increasingly being used in the treatment of adult acute lymphoblastic leukaemia (ALL). However, administering asparaginase still comes with its challenges, especially in adult patients. Therefore, it is important to understand how to manage its toxicities properly. An expert group met in November 2019 in London to discuss recent data of paediatric as well as adult studies using paediatric regimens with regard to the best management of several key toxicities that can occur in adults treated with asparaginase including hepatotoxicity, pancreatitis, hypertriglyceridaemia, thrombosis and hypersensitivity. Several recommendations were made for each one of these toxicities, with the goal of safe administration of the drug and to educate clinicians when the drug can be continued despite side effects.

【 授权许可】

CC BY|CC BY-NC-ND