Management of toxicities associated with pegaspargase in treatment of patients with lymphoid malignancy: experience from 443 cases in a single center
10.3760/cma.j.issn.0253-2727.2018.08.009
- VernacularTitle: 培门冬酶治疗淋巴系统肿瘤的不良反应及处理：来自单中心443例次的经验
- Author:
Jia CONG
1
;
Lei YANG
;
Jin YE
;
Liqiang WEI
;
Xin LI
;
Jingwen WANG
Author Information
1. Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
Pegaspargase;
Adverse effect;
Lymphoma;
Leukemia, lymphoid
- From:
Chinese Journal of Hematology
2018;39(8):654-660
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the adverse effects of pegaspargase in the treatment of lymphoid malignancies and management experience.
Methods:Clinical data of patients who received chemotherapy including pegaspargase in the Department of Hematology of Beijing Tongren hospital during August 2011 to December 2015 were retrospective analyzed, and the adverse effects of pegaspargase and the management experience was summarized.
Results:A total of 129 patients with 443 times of pegaspargase used during this period. The common adverse reactions included allergic reactions in 2 cases (1.6%), acute pancreatitis in 19 (14.7%) including 6 acute symptomatic pancreatitis and 13 chemical pancreatitis with elevated pancreatin, hypertriglyceridemia in 15 cases(11.6%), hyperglycemia in 85 (65.9%), hypoglycemia in 7 (5.4%), elevated aminotransferase in 25 (19.4%), hyperbilirubinemia in 21 (15.5%), hypoalbuminemia in 62 (48.1%), prolonged APTT in 61 (47.3%), prolonged PT in 22 (17.1%), prolonged TT in 15 (11.6%), hypofibrinogen in 75 (58.1%), thrombus in 11 (8.5%) and bleeding in 3 (2.3%). The above adverse reactions were improved by symptomatic treatment of anti allergy, inhibition of secretion of pancreatic juice, lipid lowering, hypoglycemic, liver preservation, supplementation of plasma and hemostasis, respectively. Some serious adverse reactions affected the application of pegaspargase, even lead to discontinuation of the aspartate.
Conclusion:Though adverse effects associated with pegaspargase are extensive, most patients can successfully complete the chemotherapy containing the pegaspargase with close monitoring and timely treatment.
