Abstract
The optimal use of PEG-asparaginase in relapsed ALL--lessons from the ALLR3 Clinical Trial.
Highlights
Though modern chemotherapy regimens cure over 80% of children with acute lymphoblastic leukaemia (ALL), the outcome of relapsed disease remains suboptimal
We identified 354 patients who received PEG-ASNase, 20 who received Erwinase and 16 patients who received no ASNase in the ALLR3 trial (Table 1)
Patients who developed pancreatitis (n 1⁄4 2) during frontline therapy did not receive any ASNase in ALLR3
Summary
The optimal use of PEG-Asparaginase in relapsed ALL—lessons from the ALLR3 Clinical Trial. To assess the effect of PEG-ASNase given during initial therapy on its subsequent use in relapse patients, we recruited after obtaining ethical approval and written consent, patients on the ALLR3 clinical trial who had previously been treated on the UKALL 2003 protocol. For patients treated initially with PEG-ASNase on frontline protocols who subsequently relapse, silent inactivation does not appear to pose a significant clinical problem. At the time these assays were performed, 390 patients, recruited from participating centres in UK, Netherlands, Australia and New Zealand, had completed the first three blocks of therapy containing ASNase (Supplementary Figure 1)..
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