A comparison of hypersensitivity reactions between intravenous and intramuscular applications of native E. coli asparaginase in children with acute lymphoblastic leukemia

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dc.authoridPaslı uysalol, Ezgi/0000-0001-9357-4588
dc.authoridVupa Çilengiroğlu, Özgül/0000-0003-0181-8376
dc.authoridOdaman Al, Isik/0000-0003-4292-1409
dc.authorwosidErsoy, Gizem/JAX-8473-2023
dc.authorwosidARSLANTAS, ESRA/IZQ-5302-2023
dc.authorwosidPaslı uysalol, Ezgi/GRY-6581-2022
dc.authorwosidVupa Çilengiroğlu, Özgül/JFK-9235-2023
dc.contributor.authorAl, Isik Odaman
dc.contributor.authorOzdemir, Nihal
dc.contributor.authorErsoy, Gizem Zengin
dc.contributor.authorBayram, Cengiz
dc.contributor.authorCilengiroglu, Ozgul Vupa
dc.contributor.authorArslantas, Esra
dc.contributor.authorUysalol, Ezgi Pasli
dc.date.accessioned2024-05-19T14:43:01Z
dc.date.available2024-05-19T14:43:01Z
dc.date.issued2023
dc.departmentİstinye Üniversitesien_US
dc.description.abstractIntroduction Asparaginase is an indispensable drug in treating childhood acute lymphoblastic leukemia (ALL). Hypersensitivity reactions (HSR) are the most common side effects and interfere with the antineoplastic activity of the drug. This study aims to compare the intramuscular (IM) and intravenous (IV) administration routes of Native Escherichia coli Lasparaginase (L-ASNase) in terms of hypersensitive reactions. Methods L-ASNase was randomly administered IV or IM to newly diagnosed ALL patients and HSR was monitored in all patients for 1 h following the end of the IV infusion and for 2 h following the end of the IM administration of L-ASNase. Based on a retrospective review of clinical charts, reactions were identified. In order to determine the severity of each allergic reaction, we used the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 for allergic reactions. Results A total of 1032 doses of L-ASNase were administered to 85 patients (42 males and 43 females) during the study period. Among 85 patients, 30 reactions were recorded, which means that 35% of the patients reacted. According to the CTCAE, twenty-nine out of 30 reactions (97%) were grade 2, while one (3%) was grade 4. In terms of individual doses, there was a non-significant trend toward increased incidence of reactions with IV administration (3.8% versus 0.9%, p = 0.064). The rate of reactions was higher in patients who received all IV doses (n: 60) as compared to those who received all IM doses (n: 25) (31.7% vs. 3.5%; chi-square= 8.415, p value=0.04). Based on the risk groups and HSR incidence, it was found that high risk group (HRG) patients were significantly more likely to develop HSR compared to the standart risk group (SRG) and intermediate risk group (MRG) patients (chi-square p = 0.003, CI: 95%; odds ratio: 3.12 and 5.91, respectively). Conclusions In conclusion, IM administration of L-ASNase causes significantly less HSR to L-ASNase than the IV route. Patients with HRGALL have a higher risk of HSR. Since L-ASNase is still used in many developing countries and there are problems in the supply of Erwinia chrysanthemi ASNase (Erwinia), LASNase can be administered IM to reduce the frequency of HSR.en_US
dc.identifier.doi10.1177/10781552231164503
dc.identifier.endpage1460en_US
dc.identifier.issn1078-1552
dc.identifier.issn1477-092X
dc.identifier.issue6en_US
dc.identifier.pmid36942380en_US
dc.identifier.scopus2-s2.0-85150894334en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage1454en_US
dc.identifier.urihttps://doi.org10.1177/10781552231164503
dc.identifier.urihttps://hdl.handle.net/20.500.12713/5312
dc.identifier.volume29en_US
dc.identifier.wosWOS:000954323200001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherSage Publications Ltden_US
dc.relation.ispartofJournal of Oncology Pharmacy Practiceen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240519_kaen_US
dc.subjectLeukemiaen_US
dc.subjectAsparaginaseen_US
dc.subjectHypersensitivityen_US
dc.subjectIntramuscular Applicationen_US
dc.subjectChildrenen_US
dc.titleA comparison of hypersensitivity reactions between intravenous and intramuscular applications of native E. coli asparaginase in children with acute lymphoblastic leukemiaen_US
dc.typeArticleen_US

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