Adverse reactions to Erwinia asparaginase and pegaspargase in the treatment of acute lymphoblastic leukemia in children
10.12007/j.issn.0258-4646.2025.07.006
- VernacularTitle:欧文氏菌门冬酰胺酶和培门冬酰胺酶在儿童急性淋巴细胞白血病治疗中的不良反应
- Author:
Shan HUANG
1
;
Yujie GUAN
1
;
Lili SONG
1
;
Lihuan SHI
1
;
Wei LIU
1
Author Information
1. 郑州大学附属儿童医院血液肿瘤科,郑州 450018
- Publication Type:Journal Article
- Keywords:
acute lymphoblastic leukemia;
pegaspargase;
Erwiniaasparaginase;
adverse reaction;
child
- From:
Journal of China Medical University
2025;54(7):608-612
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the adverse reactions to pegasparaginase(PEG-ASP)and Erwiniaasparaginase(ASP)in the treat-ment of pediatric acute lymphoblastic leukemia(ALL)and to provide clinical guidance for treatment.Methods A total of 13 patients who were switched from PEG-ASP to Erwinia ASP due to allergic reactions during the induction phase of ALL treatment at the Depart-ment of Hematology and Oncology,Children's Hospital Affiliated of Zhengzhou University between February 2022 and February 2023 were selected as the case group.A control group of 26 patients treated with PEG-ASP and matched for sex at a ratio of 1∶2 was also selected.Pre-and post-treatment coagulation function,blood biochemistry,blood ammonia level,and gastrointestinal reactions were compared between the groups.Results There were no significant differences in AST,TB,UB,TC,TG,AMY,UN,Cr,APTT,and Fbg levels between the two groups,pre-and post-treatment.However,ALT,GGT,BB,and Glu levels were higher in the control group,whereas albumin was lower than in the case group(P<0.05).Both groups had an increased post-treatment blood ammonia level(P<0.05),with significantly a higher level observed in the case group than in the control group(P<0.001).No significant differences in adverse gastro-intestinal reactions were observed between the two groups.Conclusion Erwinia ASP and PEG-ASP affected liver function in pediatric ALL re-induction therapy with minimal effects on coagulation and weaker gastrointestinal reaction.Erwinia ASP significantly affected the blood ammonia level,and both treatments caused mild gastrointestinal reactions.Regular blood ammonia monitoring,post Erwinia ASP treatment,is recommended.
