Respuesta Carta a Editor titulada: Reacciones de hipersensibilidad a asparaginasa

B., Pilar Ovalle; M., Manuel Azócar; D., Carolina Nicklas; C, Milena Villarroel; V., Jorge Morales

doi:10.32641/andespediatr.v92i4.3898

Cited by 1 publication

(2 citation statements)

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“…16,17 It is estimated that the PEG-asp-related anaphylaxis rate ranges from 7.7% to 44.0% in childhood ALL patients, among which rash, dyspnea, and anaphylactic shock are often reported. 9,11,18,19 Figure 2 L-asp activity and anti-L-asp antibody were related to PEG-asp-related anaphylaxis. Comparison of L-asp activity between childhood ALL patients with PEG-asp-related anaphylaxis and patients without PEG-asp-related anaphylaxis (A); between patients with PEG-asp-related non-anaphylaxis adverse reaction and patients without PEG-asp-related non-anaphylaxis adverse reaction (B); between patients with total PEG-asp-related adverse reaction and patients without PEG-asp-related adverse reaction (C).…”

Section: Discussionmentioning

confidence: 99%

“…6,7 These PEG-asp-related anaphylaxes may cause discontinuation of the therapy and reduced therapeutic efficacy, leading to a high relapse risk. 8,9 Hence, it is critical to identify some novel biomarkers to predict PEG-asp-related anaphylaxes and adverse reactions in childhood ALL patients, which might further improve their overall management.…”

Section: Introductionmentioning

confidence: 99%

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L-asparaginase activity and anti-L-asparaginase antibody as biomarkers in estimating PEG-asp-related anaphylaxis risk in childhood acute lymphoblastic leukemia patients

Cui

Lian

et al. 2023

Allergol Immunopathol

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Background: L-Asparaginase (L-asp), the unconjugated form of polyethylene glycol-conjugated L-asparaginase (PEG-asp), regulates T cell stimulation, antibody production, and lysosomal protease activity to mediate PEG-asp-related anaphylaxis. This study aimed to investigate the relation of L-asp activity and anti-L-asp antibody with anaphylaxis risk and non-anaphylaxis adverse reaction risk in childhood acute lymphoblastic leukemia (ALL) patients who underwent PEG-asp contained therapy. Methods: In total, 170 childhood ALL patients underwent PEG-asp-contained treatment and their L-asp activity and anti-L-asp antibody were detected on the 7th day after treatment initiation. Results: There were 27 (15.9%) patients who had PEG-asp-related adverse reaction: 17 (10.0%) patients experienced PEG-asp-related anaphylaxis and 14 (8.2%) patients experienced PEG- asp-related non-anaphylaxis adverse reaction. Moreover, L-asp activity was negatively related to anti-L-asp antibody in childhood ALL patients (P<0.001). Elevated L-asp activity was associated with the absence of PEG-asp-related anaphylaxis (P<0.001), PEG-asp-related non-anaphylaxis adverse reaction (P=0.004), and PEG-asp-related adverse reaction (P<0.001). However, the anti- L-asp antibody displayed opposite trend similar to L-asp activity. Receiver operating characteristic (ROC) curve analyses exhibited L-asp activity and anti-L-asp antibody exhibited superior predictive values in estimating PEG-asp-related anaphylaxis risk with area under curve (AUC) of 0.955 and 0.905, respectively compared to PEG-asp-related non-anaphylaxis adverse reaction risk with AUC of 0.730 and 0.675, respectively. Besides, patients with de novo disease, higher risk stratification, and allergic history showed trends linked with PEG-asp-related anaphylaxis risk. Conclusion: The monitoring of L-asp activity and anti-L-asp antibody maybe useful for early estimation and prevention of PEG-asp-related anaphylaxis in childhood ALL management.

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