Native and pegylated forms of L-asparaginase: the assessment of effectiveness and toxicity in acute lymphoblastic leukemia treated with Berlin–Frankfurt–Munster (BFM) protocol

Background. L-asparaginase is an integral part of chemotherapy regimens in treatment of patients with acute lymphoblastic leukemia (ALL). However, the use of L-asparaginase is limited due to wide range of adverse reactions. Our research demonstrates the toxicity effects and treatment results in pati...

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Main Authors: M. A. Shervashidze, D. S. Smirnova, T. T. Valiev, N. A. Batmanova
Format: Article
Language:Russian
Published: ABV-press 2024-12-01
Series:Онкогематология
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Online Access:https://oncohematology.abvpress.ru/ongm/article/view/973
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author M. A. Shervashidze
D. S. Smirnova
T. T. Valiev
N. A. Batmanova
author_facet M. A. Shervashidze
D. S. Smirnova
T. T. Valiev
N. A. Batmanova
author_sort M. A. Shervashidze
collection DOAJ
description Background. L-asparaginase is an integral part of chemotherapy regimens in treatment of patients with acute lymphoblastic leukemia (ALL). However, the use of L-asparaginase is limited due to wide range of adverse reactions. Our research demonstrates the toxicity effects and treatment results in patients with ALL who received native and pegylated (EG) L-asparaginase.Materials and methods. From 2013 to 2023 in the study 199 patients with newly diagnosed ALL were enrolled. Patients were treated according to the ALL IC-BFM 2009 protocol including L-asparaginase. The average age of patients was 4.6 (1–18) years. B-ALL was diagnosed in 175 (87.9 %) patients, T-ALL in 24 (12.1 %) patients. Native L-asparaginase was used in the therapy of 51 (25.6 %) patients; if allergic reactions occured, 72 (36.2 %) patients received EG asparaginase. In 76 (38.2 %) patients treatment protocol included only EG-asparaginase without native L-asparaginase history.Results. The most common adverse event was a hypersensitivity reaction – 27.6 % (n = 55), which was more common in the cohort of patients receiving native L-asparaginase. The incidence of hypercoagulation for patients treated with native L-asparaginase was 4 % and 0 % – for EG-asparaginase group. Hypocoagulation, presented as hypofibrinogenemia registered in 13 % of patients received native L-asparaginase and in 35 % for EG-asparaginase group. ancreatitis, complicated ALL treatment were diagnosed in 4 % after native L-asparaginase and 1 % after EG-asparaginase. The best 5‑year survival rates were observed in the group of patients who initially received EG-asparaginase – overall and eventfree survival were 100 and 87.5 (11.7) %, respectively (р >0.05).Conclusion. Despite the absence of convincing survival benefit in patients with newly diagnosed ALL treated with EG-asparaginase, the toxicity profile was better in contrast to native L-asparaginase.
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spelling doaj-art-16c27e8ad05846fd8f76c8989e8a8ec62025-08-20T04:00:14ZrusABV-pressОнкогематология1818-83462413-40232024-12-01194445110.17650/1818-8346-2024-19-4-44-51788Native and pegylated forms of L-asparaginase: the assessment of effectiveness and toxicity in acute lymphoblastic leukemia treated with Berlin–Frankfurt–Munster (BFM) protocolM. A. Shervashidze0D. S. Smirnova1T. T. Valiev2N. A. Batmanova3L.A. Durnov Research Institute of Pediatric Oncology and Hematology, N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaL.A. Durnov Research Institute of Pediatric Oncology and Hematology, N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaL.A. Durnov Research Institute of Pediatric Oncology and Hematology, N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; Russian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaL.A. Durnov Research Institute of Pediatric Oncology and Hematology, N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaBackground. L-asparaginase is an integral part of chemotherapy regimens in treatment of patients with acute lymphoblastic leukemia (ALL). However, the use of L-asparaginase is limited due to wide range of adverse reactions. Our research demonstrates the toxicity effects and treatment results in patients with ALL who received native and pegylated (EG) L-asparaginase.Materials and methods. From 2013 to 2023 in the study 199 patients with newly diagnosed ALL were enrolled. Patients were treated according to the ALL IC-BFM 2009 protocol including L-asparaginase. The average age of patients was 4.6 (1–18) years. B-ALL was diagnosed in 175 (87.9 %) patients, T-ALL in 24 (12.1 %) patients. Native L-asparaginase was used in the therapy of 51 (25.6 %) patients; if allergic reactions occured, 72 (36.2 %) patients received EG asparaginase. In 76 (38.2 %) patients treatment protocol included only EG-asparaginase without native L-asparaginase history.Results. The most common adverse event was a hypersensitivity reaction – 27.6 % (n = 55), which was more common in the cohort of patients receiving native L-asparaginase. The incidence of hypercoagulation for patients treated with native L-asparaginase was 4 % and 0 % – for EG-asparaginase group. Hypocoagulation, presented as hypofibrinogenemia registered in 13 % of patients received native L-asparaginase and in 35 % for EG-asparaginase group. ancreatitis, complicated ALL treatment were diagnosed in 4 % after native L-asparaginase and 1 % after EG-asparaginase. The best 5‑year survival rates were observed in the group of patients who initially received EG-asparaginase – overall and eventfree survival were 100 and 87.5 (11.7) %, respectively (р >0.05).Conclusion. Despite the absence of convincing survival benefit in patients with newly diagnosed ALL treated with EG-asparaginase, the toxicity profile was better in contrast to native L-asparaginase.https://oncohematology.abvpress.ru/ongm/article/view/973acute lymphoblastic leukemiatreatmentlasparaginasetoxicitychildren
spellingShingle M. A. Shervashidze
D. S. Smirnova
T. T. Valiev
N. A. Batmanova
Native and pegylated forms of L-asparaginase: the assessment of effectiveness and toxicity in acute lymphoblastic leukemia treated with Berlin–Frankfurt–Munster (BFM) protocol
Онкогематология
acute lymphoblastic leukemia
treatment
lasparaginase
toxicity
children
title Native and pegylated forms of L-asparaginase: the assessment of effectiveness and toxicity in acute lymphoblastic leukemia treated with Berlin–Frankfurt–Munster (BFM) protocol
title_full Native and pegylated forms of L-asparaginase: the assessment of effectiveness and toxicity in acute lymphoblastic leukemia treated with Berlin–Frankfurt–Munster (BFM) protocol
title_fullStr Native and pegylated forms of L-asparaginase: the assessment of effectiveness and toxicity in acute lymphoblastic leukemia treated with Berlin–Frankfurt–Munster (BFM) protocol
title_full_unstemmed Native and pegylated forms of L-asparaginase: the assessment of effectiveness and toxicity in acute lymphoblastic leukemia treated with Berlin–Frankfurt–Munster (BFM) protocol
title_short Native and pegylated forms of L-asparaginase: the assessment of effectiveness and toxicity in acute lymphoblastic leukemia treated with Berlin–Frankfurt–Munster (BFM) protocol
title_sort native and pegylated forms of l asparaginase the assessment of effectiveness and toxicity in acute lymphoblastic leukemia treated with berlin frankfurt munster bfm protocol
topic acute lymphoblastic leukemia
treatment
lasparaginase
toxicity
children
url https://oncohematology.abvpress.ru/ongm/article/view/973
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