Allergy Asthma Respir Dis.  2015 Jul;3(4):288-293. 10.4168/aard.2015.3.4.288.

Effectiveness of premedication and rapid desensitization in hypersensitivity to L-asparaginase

• Yoon DH
• Kang SH
• Kim HS
• Lee JW
• Yoon JS
• Chung NG
• Cho B

• KMID: 2218659
• DOI: http://doi.org/10.4168/aard.2015.3.4.288

Abstract

PURPOSE
L-asparaginase is a crucial chemotherapeutic agent for the treatment of acute lymphoblastic leukemia. However, hypersensitivity to L-asparaginase is common which limits its clinical use.
METHODS
We performed 44 cases of premedication and 3 cases of desensitization in 16 patients with hypersensitivity to L-asparaginase.
RESULTS
With premedication, 33 cases completed L-asparaginase injection with no hypersensitivity reactions. Eleven cases showed mild hypersensitivity reactions, such as urticaria. Desensitization was performed in 3 cases: in 2 cases, desensitization was successful, and in 1 case the medication was switched to Erwinia asparaginase.
CONCLUSION
Premedication and desensitization appear to be useful in helping patients receive desired doses of L-asparaginase in pediatric patients with acute lymphoblastic leukemia.

Keyword

Asparaginase; Drug hypersensitivity; Premedication; Immunologic desensitization; Acute lymphoblastic leukemia

MeSH Terms

Asparaginase
Desensitization, Immunologic
Drug Hypersensitivity
Erwinia
Humans
Hypersensitivity*
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Premedication*
Urticaria
Asparaginase

Figure

• 

  Fig. 1 Protocol for management of L-asparaginase hypersensitivity. IM, intramuscular.

• 

  Fig. 2 Flow chart of study population.

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