L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study

Santos, Amanda Cabral dos; Santos, Julia Maria Bispo dos; Lima, Elisângela da Costa; Land, Marcelo Gerardin Poirot

doi:10.1002/cnr2.1533

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…It may be in line with data published by Dos Santos et al They found that children with ALL who received less than ten doses of ASP may be at an increased risk of treatment failure only if they were in a high-risk group. However, this study did not show statistical significance for the number of asparaginase doses in children with ALL who were at standard or medium risk [25]. These and our results may indicate that occurrence of acute pancreatitis in children with ALL is not a risk factor for leukemia relapse.…”

Section: Discussioncontrasting

confidence: 86%

“…Since using asparaginase in treating ALL improves event-free survival, its early discontinuation caused by AP or other toxicities may be associated with worse outcomes [23][24][25]. Although asparaginase was discontinued in 76.6% of patients with AP in our study, both disease-and eventfree survivals were comparable to patients who received remaining doses of ASP during subsequent therapy phases.…”

Section: Discussionmentioning

confidence: 70%

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Acute Pancreatitis in Pediatric Acute Lymphoblastic Leukemia (AcuPA Study). A Nationwide Survey in Poland

Morawiak,

Salamonowicz,

Królak

et al. 2024

Preprint

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Purpose: This study aimed to identify the risk factors for acute pancreatitis (AP) and its impact on outcomes in Polish children treated for ALL. Methods: The study group included 2303 children who received intensive chemotherapy for ALL. The group was subdivided into patients with at least one episode of AP and those who did not develop AP following treatment for ALL. Results: The cumulative incidence of AP in the study group was 4.08%. Older age was an independent risk factor for AP development (OR 1.05; 95%CI: 1.006 – 1.098; p=0.03). The overall mortality related to AP was 2.13%. The probabilities of disease-free survival (p-DFS) and event-free survival (p-EFS) were 0.84 vs. 0.86, log-rank: p=0.65 and 0.75 vs. 0.80, log-rank: p=0.12, respectively in both subgroups. A total of 22 out of 94 patients (23.4%) with AP were re-exposed to asparaginase (ASP) during the subsequent phases of the treatment. Only one re-exposed to ASP patient (4.5%) developed a second episode of AP. There were no significant differences in p-DFS and p-EFS between patients re-exposed and not re-exposed to asparaginase (0.78 vs. 0.86, log-rank p=0.27 and 0.63 vs. 0.79, log-rank p=0.09 respectively). Conclusions: The incidence of AP in children with ALL is low and related to the patient’s age. AP development doesn’t seem to impact p-DFS and p-EFS in children with ALL. The recurrence of AP following re-exposure to asparaginase in patients with ALL and a history of AP is low (4.5%). Re-exposure to asparaginase after the first episode of AP doesn’t improve either p-DFS or p-EFS in children with ALL.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 70%

Acute Pancreatitis in Pediatric Acute Lymphoblastic Leukemia (AcuPA Study). A Nationwide Survey in Poland

Morawiak,

Salamonowicz,

Królak

et al. 2024

Preprint

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L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study

Santos

Lima

et al. 2021

Cancer Reports

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Background The survival of children with acute lymphoblastic leukemia (ALL) has improved due to changes in the treatment and the disease diagnosis. A significant advance was the incorporation of asparaginase. However, hypersensitivity reactions are a common cause of early discontinuation of this drug. Aim The proposed study aims to evaluate early interruptions and the influence of the number of asparaginase doses effectively administered on the prognosis of patients with ALL. Methods and Results An observational cohort study was carried out, with retrospective data collection, in medical records. The prognostic variables indicated in the protocol applied were used, and the principal outcomes were 5 years event‐free survival (EFS) and 5 years of overall survival (OS) probability. Statistical analyzes were performed using SPPS 20.0 and R. In Cox's proportional hazards model for EFS and OS, variables of prognostic importance ( n = 126 children) were: high‐risk group (HGR), by the protocol classification, and less than 10 doses of asparaginase. The increased risk of events and death in HGR, who did less than 10 doses, was 3.6 and 7 times, respectively. The study did not show statistical significance for the number of asparaginase doses in patients who were not at high risk. Conclusions We demonstrated that the early interruption of asparaginase treatment could negatively impact the prognosis of patients with ALL, especially HGR, reinforcing the need for careful diagnosis of reactions and the availability of alternative types of asparaginase.

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Acute Pancreatitis in Pediatric Acute Lymphoblastic Leukemia (AcuPA Study): A Nationwide Survey in Poland

Morawiak,

Salamonowicz-Bodzioch,

Królak

et al. 2024

Cancers

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Purpose: This study aimed to identify the risk factors for acute pancreatitis (AP) and its impact on outcomes in Polish children treated for ALL. Methods: The study group included 2303 children receiving intensive chemotherapy for ALL. The group was divided into patients with at least one episode of AP and those who did not develop AP after treatment for ALL. Results: The cumulative incidence of AP in the study group was 4.08%. Older age was an independent risk factor for the development of AP (OR = 1.05; 95%CI = 1.006–1.098; p = 0.03). The overall mortality associated with AP was 2.13%. The probabilities of disease-free survival (p-DFS) and event-free survival (p-EFS) in both subgroups were 0.84 vs. 0.86, log-rank p = 0.65 and 0.75 vs. 0.80, log-rank p = 0.12, respectively. A total of 22 out of 94 patients (23.4%) with AP were re-exposed to asparaginase (ASP) during the subsequent treatment phases. Only one patient re-exposed to ASP (4.5%) developed a second episode of AP. There were no significant differences in p-DFS and p-EFS between patients re-exposed and not re-exposed to asparaginase (0.78 vs. 0.86, log-rank p = 0.27 and 0.63 vs. 0.79, log-rank p = 0.09, respectively). Conclusions: The incidence of AP in children with ALL is low and related to patients’ age. The development of AP does not seem to influence p-DFS and p-EFS in children with ALL. Recurrence of AP after re-exposure to asparaginase in patients with ALL and a history of AP is low (4.5%). Re-exposure to asparaginase after the first episode of AP does not improve either p-DFS or p-EFS in children with ALL.

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L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study

Cited by 3 publications

References 20 publications

Acute Pancreatitis in Pediatric Acute Lymphoblastic Leukemia (AcuPA Study). A Nationwide Survey in Poland

Acute Pancreatitis in Pediatric Acute Lymphoblastic Leukemia (AcuPA Study). A Nationwide Survey in Poland

L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study

Acute Pancreatitis in Pediatric Acute Lymphoblastic Leukemia (AcuPA Study): A Nationwide Survey in Poland

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