SOHO State of the Art Updates and Next Questions: Management of Asparaginase Toxicity in Adolescents and Young Adults with Acute Lymphoblastic Leukemia

Kjeld Schmiegelow, Cecilie Utke Rank, Wendy Stock, Emily Dworkin, Inge van der Sluis

Onderzoeksoutput: Bijdrage aan tijdschriftArtikel recenserenpeer review

5 Citaten (Scopus)

Samenvatting

A wider use of L-asparaginase in the treatment of children with acute lymphoblastic leukemia has improved cure rates during recent decades and hence led to introduction of pediatric-inspired treatment protocols for adolescents and young adults. In parallel, a range of burdensome, often severe and occasionally life-threatening toxicities have become frequent, including hypersensitivity, hepatotoxicity, hypertriglyceridemia, thromboembolism, pancreatitis, and osteonecrosis. This often leads to truncation of asparaginase therapy, which at least in the pediatric population has been clearly associated with a higher risk of leukemic relapse. Many of the asparaginase induced toxicities are far more common in older patients, but since their relapse rate is still unsatisfactory, the decision to discontinue asparaginase therapy should balance the risk of toxicity with continued asparaginase therapy against the risk of relapse in the individual patient. The underlying mechanisms of most of the asparaginase induced side effects are still unclear. In this review we address the individual toxicities, known risk factors, and their clinical management.

Originele taal-2Engels
Pagina's (van-tot)725-733
Aantal pagina's9
TijdschriftClinical Lymphoma, Myeloma and Leukemia
Volume21
Nummer van het tijdschrift11
DOI's
StatusGepubliceerd - nov. 2021

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