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.contributor.authorOdaman Al, Işık
dc.contributor.authorÖzdemir, Nihal
dc.contributor.authorZengin Ersoy, Gizem
dc.contributor.authorBayram, Cengiz
dc.contributor.authorÇilengiroğlu, Özgül Vupa
dc.contributor.authorArslantaş, Esra
dc.contributor.authorPaslı Uysalol, Ezgi
dc.contributor.authorAyçiçek, Ali
dc.date.accessioned2023-03-28T06:29:24Z
dc.date.available2023-03-28T06:29:24Z
dc.date.issued2023en_US
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalıen_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.citationOdaman Al, I., Özdemir, N., Zengin Ersoy, G., Bayram, C., Çilengiroğlu, Ö. V., Arslantaş, E., Paslı Uysalol, E., Ayçiçek, A. (2023). A comparison of hypersensitivity reactions between intravenous and intramuscular applications of native E. coli asparaginase in children with acute lymphoblastic leukemia. Journal of Oncology Pharmacy Practice, 29(6), 1454-1460.en_US
dc.identifier.endpage1460en_US
dc.identifier.issn1078-1552
dc.identifier.issn1477-092X
dc.identifier.issue6en_US
dc.identifier.scopus2-s2.0-85150894334
dc.identifier.scopusqualityQ3
dc.identifier.startpage1454en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12939/3457
dc.identifier.volume29en_US
dc.identifier.wosWOS:000954323200001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorZengin Ersoy, Gizem
dc.language.isoen
dc.relation.ispartofJournal of Oncology Pharmacy Practice
dc.relation.isversionof10.1177/10781552231164503en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAsparaginaseen_US
dc.subjectChildrenen_US
dc.subjectHypersensitivityen_US
dc.subjectIntramuscular applicationen_US
dc.subjectLeukemiaen_US
dc.titleA comparison of hypersensitivity reactions between intravenous and intramuscular applications of native E. coli asparaginase in children with acute lymphoblastic leukemia
dc.typeArticle

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