Asparaginase Toxicities: Identification and Management in Patients With Acute Lymphoblastic Leukemia

Clin J Oncol Nurs. 2017 Oct 1;21(5):E248-E259. doi: 10.1188/17.CJON.E248-E259.

Abstract

Background: Acute lymphoblastic leukemia (ALL) is a common cancer in children, and outcomes have greatly improved because of the refinement of multiagent chemotherapy regimens that include intensified asparaginase therapy. Asparaginase, a cornerstone of modern pediatric chemotherapy regimens for ALL and asparaginase-containing protocols, is increasingly used in adolescent and adult patients historically treated with asparaginase-free regimens. .

Objectives: This article is an overview of commonly encountered asparaginase- associated toxicities and offers recommendations for treatment management. .

Methods: A literature review was conducted, reviewing asparaginase and common toxicities, specifically hypersensitivity, pancreatitis, thrombosis, hyperbilirubinemia, and hyperglycemia. .

Findings: The rapid identification and management of common asparaginase-associated adverse events can reduce symptom severity and limit potential interruptions to therapy, possibly improving outcomes.

Keywords: acute lymphoblastic leukemia; asparaginase; hypersensitivity; toxicities.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Antineoplastic Agents / therapeutic use*
  • Asparaginase / adverse effects*
  • Asparaginase / therapeutic use
  • Child
  • Child, Preschool
  • Drug Hypersensitivity
  • Humans
  • Hyperbilirubinemia / chemically induced
  • Hyperglycemia / chemically induced
  • Infant
  • Pancreatitis / chemically induced
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Survival Analysis
  • Venous Thromboembolism / chemically induced

Substances

  • Antineoplastic Agents
  • Asparaginase