Universal Premedication Does Not Impact Transition to Short-acting Asparaginase or Incidence of Hypersensitivity to Pegylated Asparaginase: A Single-institution Experience.

Asparaginase is a critical component of therapy for acute lymphoblastic leukemia/lymphoma but is associated with hypersensitivity reactions. Severe reactions necessitate a transition to an Erwinia asparaginase product, which requires more frequent dosing and higher costs. Children's Hospital Colorado implemented universal pegaspargase premedication in May 2020 and a retrospective analysis was conducted to compare the rates of transition to Erwinia products and hypersensitivity reactions between the preimplementation and postimplementation cohorts. In this large single-institution experience, universal premedication did not impact rates of Erwinia transition or hypersensitivity reactions.