Monitoring of the treatment with L-asparaginase in children with acute lymphoblastic leukemia – focus on silent inactivation and its influence on the treatment outcome

Malgorzata Czogala; Iwona Rogatko; Katarzyna Pawińska-Wąsikowska; Wojciech Czogała; Wioletta Bal; Małgorzata Ciebiera; Radosław Chaber; Agnieszka Chodała-Grzywacz; Grażyna Karolczyk; Krystyna Sztefko; Walentyna Balwierz; Szymon Skoczeń

doi:10.5114/wo.2023.124972

eISSN: 1897-4309
ISSN: 1428-2526

Contemporary Oncology/Współczesna Onkologia

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abstract:

Original paper

Monitoring of the treatment with L-asparaginase in children with acute lymphoblastic leukemia – focus on silent inactivation and its influence on the treatment outcome

Malgorzata Czogala

¹

,

Iwona Rogatko

²

,

Katarzyna Pawińska-Wąsikowska

¹

,

Wojciech Czogała

¹

,

Wioletta Bal

³

,

Małgorzata Ciebiera

⁴

,

Radosław Chaber

³

,

Agnieszka Chodała-Grzywacz

⁵

,

Grażyna Karolczyk

⁵

,

Krystyna Sztefko

²

,

Walentyna Balwierz

¹

,

Szymon Skoczeń

¹

Department of Paediatric Oncology and Haematology, Institute of Paediatrics, Jagiellonian University Medical College, Krakow, Poland
Department of Clinical Biochemistry, Institute of Paediatrics, Jagiellonian University Medical College, Kraków, Poland
Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
Clinic of Paediatric Oncology and Haematology, State Hospital 2, Rzeszow, Poland
Department of Paediatric Haematology and Oncology, Regional Polyclinic Hospital in Kielce, Kielce, Poland

Contemp Oncol (Pozn) 2022; 26 (4): 282–288

DOI: https://doi.org/10.5114/wo.2023.124972

Online publish date: 2023/01/30

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AMA

Czogala M, Rogatko I, Pawińska-Wąsikowska K, et al. Monitoring of the treatment with L-asparaginase in children with acute lymphoblastic leukemia – focus on silent inactivation and its influence on the treatment outcome. Contemporary Oncology/Współczesna Onkologia. 2022;26(4):282-288. doi:10.5114/wo.2023.124972.

APA

Czogala, M., Rogatko, I., Pawińska-Wąsikowska, K., Czogała, W., Bal, W.,  & Ciebiera, M. et al. (2022). Monitoring of the treatment with L-asparaginase in children with acute lymphoblastic leukemia – focus on silent inactivation and its influence on the treatment outcome. Contemporary Oncology/Współczesna Onkologia, 26(4), 282-288. https://doi.org/10.5114/wo.2023.124972

Chicago

Czogala, Malgorzata, Iwona Rogatko, Katarzyna Pawińska-Wąsikowska, Wojciech Czogała, Wioletta Bal, Małgorzata Ciebiera,  and Radosław Chaber et al. 2022. "Monitoring of the treatment with L-asparaginase in children with acute lymphoblastic leukemia – focus on silent inactivation and its influence on the treatment outcome". Contemporary Oncology/Współczesna Onkologia 26 (4): 282-288. doi:10.5114/wo.2023.124972.

Harvard

Czogala, M., Rogatko, I., Pawińska-Wąsikowska, K., Czogała, W., Bal, W., Ciebiera, M., Chaber, R., Chodała-Grzywacz, A., Karolczyk, G., Sztefko, K., Balwierz, W.,  and Skoczeń, S. (2022). Monitoring of the treatment with L-asparaginase in children with acute lymphoblastic leukemia – focus on silent inactivation and its influence on the treatment outcome. Contemporary Oncology/Współczesna Onkologia, 26(4), pp.282-288. https://doi.org/10.5114/wo.2023.124972

MLA

Czogala, Malgorzata et al. "Monitoring of the treatment with L-asparaginase in children with acute lymphoblastic leukemia – focus on silent inactivation and its influence on the treatment outcome." Contemporary Oncology/Współczesna Onkologia, vol. 26, no. 4, 2022, pp. 282-288. doi:10.5114/wo.2023.124972.

Vancouver

Czogala M, Rogatko I, Pawińska-Wąsikowska K, Czogała W, Bal W, Ciebiera M et al. Monitoring of the treatment with L-asparaginase in children with acute lymphoblastic leukemia – focus on silent inactivation and its influence on the treatment outcome. Contemporary Oncology/Współczesna Onkologia. 2022;26(4):282-288. doi:10.5114/wo.2023.124972.

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Introduction:
The aim of the study was to analyse the frequency of silent inactivation and allergic reaction to asparaginase (ASP) and its impact on treatment results in patients with lymphoblastic leukaemia.

Material and methods:
Seventy patients with acute lymphoblastic leukaemia treated with ASP were enrolled in the study. Asparaginase activity was monitored. The patients were switched to another ASP formulation after allergy or inactivation. The treatment results were analysed.

Results:
Silent inactivation of native E. coli ASP was diagnosed in 5 patients (7%) and allergy in 34 patients (49%), and these patients were switched to pegylated ASP (PEG-ASP). Silent inactivation of PEG-ASP occurred in 8 patients (23%) and allergy in 6 patients (17%). Eight children continued therapywith Erwinase, and 4 did not switch to Erwinase after inactivation of PEG-ASP. Allergy to Erwinase occurred in 2 patients (22%); there was no inactivation. No significant differences in outcome were found between the groups of patients with and without allergy or silent inactivation of ASP. Due to regular monitoring and switchingto other ASP preparations after allergyor silent inactivation, therapeutic activity was ensured in almost all patients.

Conclusions:
Monitoring of ASP activity is crucial to recognize silent inactivation and to guarantee treatment effectiveness by switching to other ASP preparations.

keywords:

Monitoring of the treatment with L-asparaginase in children with acute lymphoblastic leukemia – focus on silent inactivation and its influence on the treatment outcome

Malgorzata Czogala 1 , Iwona Rogatko 2 , Katarzyna Pawińska-Wąsikowska 1 , Wojciech Czogała 1 , Wioletta Bal 3 , Małgorzata Ciebiera 4 , Radosław Chaber 3 , Agnieszka Chodała-Grzywacz 5 , Grażyna Karolczyk 5 , Krystyna Sztefko 2 , Walentyna Balwierz 1 , Szymon Skoczeń 1

asparaginase, acute lymphoblastic leukaemia, allergy, silent inactivation, children