Prevention and management of asparaginase/pegasparaginase-associated toxicities in adults and older adolescents: Recommendations of an expert panel Journal Article
| Authors: | Stock, W.; Douer, D.; DeAngelo, D. J.; Arellano, M.; Advani, A.; Damon, L.; Kovacsovics, T.; Litzow, M.; Rytting, M.; Borthakur, G.; Bleyer, A. |
| Article Title: | Prevention and management of asparaginase/pegasparaginase-associated toxicities in adults and older adolescents: Recommendations of an expert panel |
| 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. © 2011 Informa UK, Ltd. |
| Keywords: | adolescent; adult; cancer survival; antibiotic therapy; prednisone; fatigue; dose response; drug dose reduction; drug efficacy; drug withdrawal; side effect; treatment duration; antineoplastic agents; drug megadose; neurotoxicity; nuclear magnetic resonance imaging; low drug dose; computer assisted tomography; liver toxicity; bleeding; nausea; neuropathy; vomiting; oxygen; incidence; drug dosage form comparison; exercise; dexamethasone; steroid; vincristine; anticoagulant therapy; patient monitoring; practice guideline; age factors; continuous infusion; age; abdominal pain; aspartate aminotransferase blood level; drug hypersensitivity; hyperglycemia; hypotension; prothrombin time; survival time; diet; nonhodgkin lymphoma; paracetamol; stroke; thromboembolism; thrombosis; family history; prophylaxis; escherichia coli; pancreatitis; practice guidelines as topic; daunorubicin; brain disease; drug clearance; asparaginase; insulin; glucose blood level; precursor cell lymphoblastic leukemia-lymphoma; glucose; bulimia; hyperbilirubinemia; octreotide; seizure; vinca alkaloid; drug blood level; acute lymphocytic leukemia; hydrocortisone; drug half life; somnolence; drug substitution; anthracycline; coma; guidelines; brain ischemia; epistaxis; metabolic disorder; oral contraception; toxicities; treatment withdrawal; leukoencephalopathy; hypertriglyceridemia; polyethylene glycols; urticaria; infusion fluid; fibrinogen; fibrinogen blood level; antihistaminic agent; low molecular weight heparin; partial thromboplastin time; angioneurotic edema; anticoagulant agent; blood clotting factor 8; diphenhydramine; steroid therapy; adults; cryoprecipitate; wheezing; lactulose; hypertransaminasemia; larynx spasm; adrenalin; fresh frozen plasma; hyperammonemia; international normalized ratio; skin bruising; albumin blood level; imipenem; glycemic control; asparaginase macrogol; polydipsia; polyuria; pegasparaginase; insulin treatment; 4 aminophenol; gemfibrozil; nafamstat mesilate; erwinia; glucosuria; hypofibrinogemia; intravenous catheter; ketoacidosis; uremia |
| Journal Title: | Leukemia and Lymphoma |
| Volume: | 52 |
| Issue: | 12 |
| ISSN: | 1042-8194 |
| Publisher: | Taylor & Francis Group |
| Date Published: | 2011-12-01 |
| Start Page: | 2237 |
| End Page: | 2253 |
| Language: | English |
| DOI: | 10.3109/10428194.2011.596963 |
| PROVIDER: | scopus |
| PUBMED: | 21827361 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 3" - "Export Date: 1 February 2012" - "CODEN: LELYE" - "Source: Scopus" |
