Pegaspargase Rechallenge Following Grade 2 Hypersensitivity Reaction in Childhood Acute Lymphoblastic Leukemia: Results of DFCI 16‐001
Melissa A. Burns, Yael Flamand, Julia Keating, Victoria Koch, Sarah M. Cronholm, Sarah K. Hunt, Peter D. Cole, Lisa M. Gennarini, Nobuko Hijiya, Justine M. Kahn, Kara M. Kelly, Bruno Michon, Donna S. Neuberg, Andrew E. Place, Caroline Laverdière, Thai Hoa Tran, Yves Théorêt, Jennifer J. G. Welch, Stephen E. Sallan, Lewis B. Silverman, Lynda M. VroomanABSTRACT
Hypersensitivity reactions with pegylated Escherichia coli –derived asparaginase formulations are frequent and can complicate delivery of intended therapy for patients with acute lymphoblastic leukemia (ALL). On DFCI 16‐001, which enrolled patients aged 1–21 years with newly diagnosed ALL, we piloted pegaspargase rechallenge after Grade 2 hypersensitivity reaction, including premedication and serum asparaginase activity (SAA) assessment. Among those who underwent rechallenge, the rechallenge dose was successfully administered (without reaction and with adequate SAA) in 41.3% of patients. This approach reduces the number of patients requiring switch to alternative asparaginase formulations, which have had limited availability and require frequent dosing.