The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026
Prevention of Subsequent L-Asparaginase Hypersensitivity in Children Through Premedication: A Single-Center Experience.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Saligupta Pongsathorn, Choed-Amphai Chane, Sathitsamitphong Lalita, Lao-Araya Mongkol
Аннотация
OBJECTIVE: L-asparaginase is an essential component of pediatric acute lymphoblastic leukemia (ALL) treatment. However, hypersensitivity reactions can occur, necessitating a switch to alternative asparaginase formulations. In resource-limited settings, access to pegylated asparaginase and Erwinia asparaginase may be limited. This study aimed to evaluate the safety and feasibility of a premedication protocol in preventing subsequent L-asparaginase hypersensitivity reactions in children with a history of severe reactions to native Escherichia coli L-asparaginase.
METHODS: A retrospective cohort study was conducted in 119 children with ALL treated with L-asparaginase at Chiang Mai University Hospital. Ten patients (8.4%) developed severe systemic hypersensitivity reactions. Subsequent intramuscular L-asparaginase doses were preceded by a standardized premedication protocol comprising oral prednisolone, cetirizine, and montelukast, along with preinfusion intravenous hydrocortisone.
RESULTS: A total of 76 subsequent L-asparaginase doses were administered following premedication. Seven episodes (9.2%) of recurrent hypersensitivity reactions occurring within 5 to 40 minutes of L-asparaginase dosing occurred in 6 patients. Most reactions were mild and managed with additional antihistamines and corticosteroids. One episode required treatment with intramuscular epinephrine. All patients successfully completed their prescribed course of L-asparaginase therapy.
CONCLUSION: In resource-limited settings, our premedication protocol demonstrated potential for safely enabling continued native E. coli L-asparaginase therapy in children with a history of severe hypersensitivity reactions, thus potentially improving access to chemotherapy treatment.
METHODS: A retrospective cohort study was conducted in 119 children with ALL treated with L-asparaginase at Chiang Mai University Hospital. Ten patients (8.4%) developed severe systemic hypersensitivity reactions. Subsequent intramuscular L-asparaginase doses were preceded by a standardized premedication protocol comprising oral prednisolone, cetirizine, and montelukast, along with preinfusion intravenous hydrocortisone.
RESULTS: A total of 76 subsequent L-asparaginase doses were administered following premedication. Seven episodes (9.2%) of recurrent hypersensitivity reactions occurring within 5 to 40 minutes of L-asparaginase dosing occurred in 6 patients. Most reactions were mild and managed with additional antihistamines and corticosteroids. One episode required treatment with intramuscular epinephrine. All patients successfully completed their prescribed course of L-asparaginase therapy.
CONCLUSION: In resource-limited settings, our premedication protocol demonstrated potential for safely enabling continued native E. coli L-asparaginase therapy in children with a history of severe hypersensitivity reactions, thus potentially improving access to chemotherapy treatment.