Intravenous PEG-asparaginase during remission induction in children and adolescents with newly diagnosed acute lymphoblastic leukemia

Lewis B. Silverman, Jeffrey G. Supko, Kristen E. Stevenson, Christina Woodward, Lynda M. Vrooman, Donna S. Neuberg, Barbara L. Asselin, Uma H. Athale, Luis Clavell, Peter D. Cole, Kara M. Kelly, Caroline Laverdière, Bruno Michon, Marshall Schorin, Cindy L. Schwartz, Jane E. O'Brien, Harvey J. Cohen, Stephen E. Sallan

Research output: Contribution to journalArticle

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Abstract

Over the past several decades, L-asparaginase, an important component of therapy for acute lymphoblastic leukemia (ALL), has typically been administered intramuscularly rather than intravenously in North America because of concerns regarding anaphylaxis.We evaluated the feasibility of giving polyethylene glycosylated (PEG)-asparaginase, the polyethylene glycol conjugate of Escherichia coli L-asparaginase, by intravenous infusion in children with ALL. Between 2005 and 2007, 197 patients (age, 1-17 years) were enrolled on Dana-Farber Cancer Institute ALL Consortium Protocol 05-01 and received a single dose of intravenous PEG-asparaginase (2500 IU/m2) over 1 hour during emission induction. Serum asparaginase activity more than 0.1 IU/mL was detected in 95%, 88%, and 7% of patients at 11, 18, and 25 days after dosing, respectively. Toxicities included allergy (1.5%), venous thrombosis (2%), and pancreatitis (4.6%). We conclude that intravenous administration of PEG-asparaginase is tolerable in children with ALL, and potentially therapeutic enzyme activity is maintained for at least 2 weeks after a single dose in most patients. This trial was registered at www.clinicaltrials.gov as #NCT00400946. (Blood. 2010;115:1351-1353)

Original languageEnglish (US)
Pages (from-to)1351-1353
Number of pages3
JournalBlood
Volume115
Issue number7
DOIs
StatePublished - Feb 18 2010

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Remission Induction
Asparaginase
Polyethylene
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Allergies
Enzyme activity
Anaphylaxis
North America
Intravenous Infusions
Venous Thrombosis
Pancreatitis
Intravenous Administration
Escherichia coli
Toxicity
Hypersensitivity
Blood
Enzymes
Therapeutics
Serum
Neoplasms

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Silverman, L. B., Supko, J. G., Stevenson, K. E., Woodward, C., Vrooman, L. M., Neuberg, D. S., ... Sallan, S. E. (2010). Intravenous PEG-asparaginase during remission induction in children and adolescents with newly diagnosed acute lymphoblastic leukemia. Blood, 115(7), 1351-1353. https://doi.org/10.1182/blood-2009-09-245951

Intravenous PEG-asparaginase during remission induction in children and adolescents with newly diagnosed acute lymphoblastic leukemia. / Silverman, Lewis B.; Supko, Jeffrey G.; Stevenson, Kristen E.; Woodward, Christina; Vrooman, Lynda M.; Neuberg, Donna S.; Asselin, Barbara L.; Athale, Uma H.; Clavell, Luis; Cole, Peter D.; Kelly, Kara M.; Laverdière, Caroline; Michon, Bruno; Schorin, Marshall; Schwartz, Cindy L.; O'Brien, Jane E.; Cohen, Harvey J.; Sallan, Stephen E.

In: Blood, Vol. 115, No. 7, 18.02.2010, p. 1351-1353.

Research output: Contribution to journalArticle

Silverman, LB, Supko, JG, Stevenson, KE, Woodward, C, Vrooman, LM, Neuberg, DS, Asselin, BL, Athale, UH, Clavell, L, Cole, PD, Kelly, KM, Laverdière, C, Michon, B, Schorin, M, Schwartz, CL, O'Brien, JE, Cohen, HJ & Sallan, SE 2010, 'Intravenous PEG-asparaginase during remission induction in children and adolescents with newly diagnosed acute lymphoblastic leukemia', Blood, vol. 115, no. 7, pp. 1351-1353. https://doi.org/10.1182/blood-2009-09-245951
Silverman, Lewis B. ; Supko, Jeffrey G. ; Stevenson, Kristen E. ; Woodward, Christina ; Vrooman, Lynda M. ; Neuberg, Donna S. ; Asselin, Barbara L. ; Athale, Uma H. ; Clavell, Luis ; Cole, Peter D. ; Kelly, Kara M. ; Laverdière, Caroline ; Michon, Bruno ; Schorin, Marshall ; Schwartz, Cindy L. ; O'Brien, Jane E. ; Cohen, Harvey J. ; Sallan, Stephen E. / Intravenous PEG-asparaginase during remission induction in children and adolescents with newly diagnosed acute lymphoblastic leukemia. In: Blood. 2010 ; Vol. 115, No. 7. pp. 1351-1353.
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AU - Silverman, Lewis B.

AU - Supko, Jeffrey G.

AU - Stevenson, Kristen E.

AU - Woodward, Christina

AU - Vrooman, Lynda M.

AU - Neuberg, Donna S.

AU - Asselin, Barbara L.

AU - Athale, Uma H.

AU - Clavell, Luis

AU - Cole, Peter D.

AU - Kelly, Kara M.

AU - Laverdière, Caroline

AU - Michon, Bruno

AU - Schorin, Marshall

AU - Schwartz, Cindy L.

AU - O'Brien, Jane E.

AU - Cohen, Harvey J.

AU - Sallan, Stephen E.

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N2 - Over the past several decades, L-asparaginase, an important component of therapy for acute lymphoblastic leukemia (ALL), has typically been administered intramuscularly rather than intravenously in North America because of concerns regarding anaphylaxis.We evaluated the feasibility of giving polyethylene glycosylated (PEG)-asparaginase, the polyethylene glycol conjugate of Escherichia coli L-asparaginase, by intravenous infusion in children with ALL. Between 2005 and 2007, 197 patients (age, 1-17 years) were enrolled on Dana-Farber Cancer Institute ALL Consortium Protocol 05-01 and received a single dose of intravenous PEG-asparaginase (2500 IU/m2) over 1 hour during emission induction. Serum asparaginase activity more than 0.1 IU/mL was detected in 95%, 88%, and 7% of patients at 11, 18, and 25 days after dosing, respectively. Toxicities included allergy (1.5%), venous thrombosis (2%), and pancreatitis (4.6%). We conclude that intravenous administration of PEG-asparaginase is tolerable in children with ALL, and potentially therapeutic enzyme activity is maintained for at least 2 weeks after a single dose in most patients. This trial was registered at www.clinicaltrials.gov as #NCT00400946. (Blood. 2010;115:1351-1353)

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