Pegaspargase Rechallenge Following Grade 2 Hypersensitivity Reaction in Childhood Acute Lymphoblastic Leukemia: Results of DFCI 16-001.
In DFCI 16-001, pegaspargase rechallenge with premedication and serum asparaginase activity monitoring after grade 2 hypersensitivity was successful—defined as no recurrent reaction and adequate activity—in 41.3% of rechallenged children and young adults with newly diagnosed ALL.
Open original publication →What the AI sees
In DFCI 16-001, pegaspargase rechallenge with premedication and serum asparaginase activity monitoring after grade 2 hypersensitivity was successful—defined as no recurrent reaction and adequate activity—in 41.3% of rechallenged children and young adults with newly diagnosed ALL.
Research significance
The record provides evidence that selected patients with grade 2 pegaspargase hypersensitivity can sometimes receive a successful monitored rechallenge; it supports, but does not establish, the hypothesis that this strategy could preserve intended asparaginase therapy and reduce reliance on less available, more frequently dosed alternatives without unacceptable risk.
Source abstract
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.