Prevention and management of asparaginase/pegasparaginase-associated toxicities in adults and older adolescents: Recommendations of an expert panel

Wendy Stock, Dan Douer, Daniel J. Deangelo, Martha Arellano, Anjali Advani, Lloyd Damon, Tibor Kovacsovics, Mark R Litzow, Michael Rytting, Gautam Borthakur, Archie Bleyer

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

The rapidly increasing use of pegasparaginase (pegASNase) in adults, after a half century of use of asparaginase (ASNase) in children, has prompted a need for guidelines in the management and prevention of toxicities of asparagine depletion in adults. Accordingly, an initial set of recommendations are provided herein. Major advantages of pegASNase are its 23-week duration of action, in contrast to less than 3 days with native ASNase, and the flexibility of intravenous or intramuscular administration of pegASNase and associated patient and physician convenience. The most frequent toxicities of both types of ASNase are hepatic and pancreatic, with pancreatitis being the most serious. Other toxicities are hypersensitivity reactions, thrombosis, nausea/vomiting, and fatigue. Whether or not the replacement of one dose of pegASNase for 69 doses of native ASNase can be achieved in adults with similar efficacy and acceptable toxicities to those achieved in children remains to be established.

Original languageEnglish (US)
Pages (from-to)2237-2253
Number of pages17
JournalLeukemia and Lymphoma
Volume52
Issue number12
DOIs
StatePublished - Dec 2011

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Asparaginase
Asparagine
Pancreatitis
Nausea
Vomiting
Fatigue
Hypersensitivity
Thrombosis
Guidelines
Physicians
Liver

Keywords

  • Adults
  • Asparaginase
  • Guidelines
  • Pegasparaginase
  • Toxicities

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Prevention and management of asparaginase/pegasparaginase-associated toxicities in adults and older adolescents : Recommendations of an expert panel. / Stock, Wendy; Douer, Dan; Deangelo, Daniel J.; Arellano, Martha; Advani, Anjali; Damon, Lloyd; Kovacsovics, Tibor; Litzow, Mark R; Rytting, Michael; Borthakur, Gautam; Bleyer, Archie.

In: Leukemia and Lymphoma, Vol. 52, No. 12, 12.2011, p. 2237-2253.

Research output: Contribution to journalArticle

Stock, W, Douer, D, Deangelo, DJ, Arellano, M, Advani, A, Damon, L, Kovacsovics, T, Litzow, MR, Rytting, M, Borthakur, G & Bleyer, A 2011, 'Prevention and management of asparaginase/pegasparaginase-associated toxicities in adults and older adolescents: Recommendations of an expert panel', Leukemia and Lymphoma, vol. 52, no. 12, pp. 2237-2253. https://doi.org/10.3109/10428194.2011.596963
Stock, Wendy ; Douer, Dan ; Deangelo, Daniel J. ; Arellano, Martha ; Advani, Anjali ; Damon, Lloyd ; Kovacsovics, Tibor ; Litzow, Mark R ; Rytting, Michael ; Borthakur, Gautam ; Bleyer, Archie. / Prevention and management of asparaginase/pegasparaginase-associated toxicities in adults and older adolescents : Recommendations of an expert panel. In: Leukemia and Lymphoma. 2011 ; Vol. 52, No. 12. pp. 2237-2253.
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