Allergologia et immunopathologia · 2026
Case series of desensitization to pegylated escherichia coli-derived asparaginase: An effective option in response to the need.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Ortega Natalhie Acuña, Díaz Sandra N González, De Lira Quezada Cindy E, Ruiz Ana K Chávez, Pedraza Julia E Colunga, González Danna S Ríos
Аннотация
INTRODUCTION: Asparaginase is an integral component in the treatment of acute lymphoblastic leukemia. The asparaginase products available in our country are Escherichia Coli (E. Coli)-derived asparaginase (Leunase), pegaspargase (Oncaspar), and, to a lesser extent, Erwinia chrysanthemi-derived asparaginase. Hypersensitivity reactions (HSR) are reported less frequently in those receiving pegaspargase, ranging from 3% to 15%; however, these reactions can limit its use in this population.
CASE REPORT: We present four patients with B-cell ALL who experienced a severe allergic HSR, anaphylaxis, leading us to perform a 12-step desensitization protocol to pegaspargase to ensure that the patients received first-line treatment for their oncologic condition.
MANAGEMENT AND OUTCOMES: Skin tests were performed, with positive results in two out of four patients. Subsequently, a 12-step desensitization protocol was carried out. Pegaspargase was diluted with 0.9% saline solution in three bags (concentrations 1:100, 1:10, and 1:1). Infusions used four steps per bag titrated every 15 minutes up to a maximum rate of 80 mL/hour for step 12. A successful administration of pegaspargase was achieved, and the patients continued with their ALL treatment.
CASE REPORT: We present four patients with B-cell ALL who experienced a severe allergic HSR, anaphylaxis, leading us to perform a 12-step desensitization protocol to pegaspargase to ensure that the patients received first-line treatment for their oncologic condition.
MANAGEMENT AND OUTCOMES: Skin tests were performed, with positive results in two out of four patients. Subsequently, a 12-step desensitization protocol was carried out. Pegaspargase was diluted with 0.9% saline solution in three bags (concentrations 1:100, 1:10, and 1:1). Infusions used four steps per bag titrated every 15 minutes up to a maximum rate of 80 mL/hour for step 12. A successful administration of pegaspargase was achieved, and the patients continued with their ALL treatment.