Outcomes and adverse events in older acute lymphoblastic Leukemia patients treated with a pediatric-inspired protocol with Pegylated or native Asparaginase
Maria Agustina Perusini,
Claire Andrews,
Eshetu G. Atenafu,
Vikas Gupta,
Dawn Maze,
Andre C. Schuh,
Karen WL. Yee,
Aniket Bankar,
Marta B. Davidson,
Guillaume Richard-Carpentier,
Steven M. Chan,
Jad Sibai,
Aaron D. Schimmer,
Mark D. Minden,
Hassan Sibai
Affiliations
Maria Agustina Perusini
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Claire Andrews
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Eshetu G. Atenafu
Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada
Vikas Gupta
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Dawn Maze
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Andre C. Schuh
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Karen WL. Yee
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Aniket Bankar
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Marta B. Davidson
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Guillaume Richard-Carpentier
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Steven M. Chan
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Jad Sibai
University Health Network, Toronto, Canada
Aaron D. Schimmer
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Mark D. Minden
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
Hassan Sibai
Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
ABSTRACTThis retrospective report presents the outcomes and adverse events (AEs) observed in 73 patients aged 60 years or older diagnosed with Philadelphia Chromosome-negative Acute Lymphoblastic Leukemia (Ph-negative ALL) treated with a pediatric-inspired protocol incorporating either Pegylated (PEG-ASP) or Native Asparaginase (EC-ASP). Notably, 61% of patients experienced AEs of Grade III-IV severity. The most prevalent AEs included thrombosis (35.6%), febrile neutropenia (38.4%), and transaminitis (34.2%). AEs did not translate into significant differences concerning overall survival, leukemia-free survival, or early mortality. Furthermore, we observed a reduction in early mortality rates (11% vs. 20%) and an increase in median overall survival (54 vs. 48 months) compared to our previous data. These findings suggest that the utilization of a pediatric-inspired chemotherapy protocol, with ASP, is an effective and well-tolerated therapeutic option for older patients with Ph-negative ALL. However, it emphasizes the importance of diligent monitoring and close follow-up throughout treatment.
