Tolerability and toxicity of pegaspargase in adults 40 years and older with acute lymphoblastic leukemia Journal Article


Authors: Daley, R. J.; Rajeeve, S.; Kabel, C. C.; Pappacena, J. J.; Stump, S. E.; Lavery, J. A.; Tallman, M. S.; Geyer, M. B.; Park, J. H.
Article Title: Tolerability and toxicity of pegaspargase in adults 40 years and older with acute lymphoblastic leukemia
Abstract: Pegaspargase is a modified version of asparaginase with prolonged asparagine depletion. It appears to be safe in adults <40 years old, but has a unique spectrum of toxicities, the risks of which appear to increase with age. The primary objective of this study was to evaluate pegaspargase tolerability and toxicity as assessed by evaluation of incidence and severity of adverse events. Secondary objectives included characterization of the reasons underlying pegaspargase discontinuation, when applicable. Grade 3/4 asparaginase-related toxicities with ≥10% incidence included: hyperbilirubinemia, hyperglycemia, hypertriglyceridemia, hypoalbuminemia, hypofibrinogenemia, and transaminitis. 63% of patients (38 of 60) received all intended doses of pegaspargase, with the most common reasons for discontinuation noted as hypersensitivity (12%), hyperbilirubinemia/transaminitis (8%), and hematopoietic transplantation in complete remission (10%). This study suggests that while hepatotoxicity and other known adverse effects are common, with careful monitoring, pegaspargase can safely be administered to adults with ALL age ≥40 years old. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
Keywords: adult; leukemia; all; pegaspargase; lymphoblastic
Journal Title: Leukemia and Lymphoma
Volume: 62
Issue: 1
ISSN: 1042-8194
Publisher: Taylor & Francis Group  
Date Published: 2021-01-01
Start Page: 176
End Page: 184
Language: English
DOI: 10.1080/10428194.2020.1824068
PUBMED: 32985296
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 February 2021 -- Source: Scopus
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MSK Authors
  1. Martin Stuart Tallman
    649 Tallman
  2. Jae Hong Park
    356 Park
  3. Ryan Joseph Daley
    15 Daley
  4. Mark Blaine Geyer
    83 Geyer
  5. Charlene Claire Kabel
    15 Kabel
  6. Jessica Ann Lavery
    79 Lavery
  7. Sarah E Stump
    12 Stump