Hematology (Dec 2024)

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

DOI
https://doi.org/10.1080/16078454.2024.2329027
Journal volume & issue
Vol. 29, no. 1

Abstract

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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.

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