Comparison of hypersensitivity reactions to PEG-asparaginase in children after intravenous and intramuscular administration

Keith J. August, Weston P. Miller, Amanda Dalton, Sara Shinnick

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

INTRODUCTION:: Polyethylene-glycolated (PEG)-asparaginase (PEG-ASP) is a crucial component of pediatric acute lymphoblastic leukemia therapy. Although hypersensitivity reactions to PEG-ASP occur less frequently than with other formulations, they are not uncommon and have an adverse impact on patient outcomes. Intravenous (IV) administration of PEG-ASP reduces patient pain and anxiety and is being used with increasing frequency in children. MATERIALS AND METHODS:: A retrospective review was performed to compare the incidence of hypersensitivity reactions to PEG-ASP in children when administered either by intramuscular (IM) or IV routes between January 2006 and May 2008. RESULTS:: Of 68 patients studied, 7 experienced a hypersensitivity reaction (10.3%). Two of 16 patients (12.5%) who received only IV PEG-ASP and 3 of 27 patients (11.1%) exposed to only IM PEG-ASP experienced a hypersensitivity reaction. Severe reactions (grade 3 or 4) occurred only once after 119 total doses (0.8%) of IV PEG-ASP and once after 215 total doses (0.5%) of IM PEG-ASP (P=1.0). Thrombosis or pancreatitis were rare and were not increased after IV PEG-ASP administration. DISCUSSION:: IV PEG-ASP is well tolerated and does not result in a significant increase in the incidence of hypersensitivity reactions in children.

Original languageEnglish (US)
Pages (from-to)e283-e286
JournalJournal of pediatric hematology/oncology
Volume35
Issue number7
DOIs
StatePublished - Oct 1 2013

Keywords

  • acute lymphoblastic leukemia
  • asparaginase
  • hypersensitivity reactions
  • pediatrics

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