Multiple Reactions and Increased Infusion Time During Desensitization May Decrease the Efficacy of Pegaspargase Chemotherapy

Abstract

Asparaginase therapy improves survival in Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma and is considered a critical component of chemotherapy. However, 10-25% of patients experience immediate hypersensitivity reactions to the preferred asparaginase chemotherapeutic agent, pegaspargase. In the setting of limited supply of the main alternative agent, Erwinia asparaginase, patients may not be able to receive asparaginase therapy unless they undergo desensitization. While cases of successful desensitizations to pegaspargase have been described, our center’s experience has demonstrated challenges in effectively desensitizing these patients.