(007) Adverse Event Outcomes When Changing Front-line Asparaginase Products for Leukemia Patients At A Children’s Hospital

Poster Abstract: L-asparagine is a nonessential amino acid synthesized by the transamination of L-aspartic acid by a reaction catalyzed by the enzyme L-asparagine synthetase. Acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (ALLy) lymphoblasts are asparagine-dependent as they lack inherent asparagine synthetase activity making them especially susceptible to plasma asparagine depletion. Contemporary ALL/ALLy therapy relies on long-acting E. coli asparaginase products as a backbone of therapy. In December of 2022 pegaspargase (Oncospar®, PEGASP) stopped being administered to pediatric patients < 22 years of age and calaspargase (Asparlas®, CALPEG) was the only available long-acting asparaginase product due to manufacturer distribution practices in the USA.. In the event of hypersensitivity to PEGASP or CALPEG, replacement with protocol-defined duration of short-acting asparaginase-erwinia chrysanthemi (Rylaze®, ERW) Is done. Adverse events that may preclude continued administration are not uncommon with any of the asparaginase products but data confirming the incidence of thrombosis, pancreatitis, or typhlitis following the change in front-line asparaginase product is limited.
This trial will compare the rates of adverse events between asparaginase products (CALPEG, PEGASP, ERW) in patients with B-cell and T-cell leukemia/lymphoma at a large tertiary care children’s hospital.
This is a retrospective observational study from October 2021 to December 2023 that will compare the rates and severity of adverse events associated with asparaginase products in patients with B-cell and T-cell leukemia/lymphomas at a large children’s hospital. Patients are to be assessed for: (1) rates of thrombosis, (2) rates of infusion reactions, (3) rates of pancreatitis, (4) rates of typhlitis, or neutropenic enterocolitis, following asparaginase administrations.
The rates of asparaginase-associated adverse events following a first-line therapy change in leukemia patients were reviewed and described at a children’s hospital.

References (must also be included in final poster): Menig S, Dinh A, Angus J, et al. Lack of benefit from premedication for pegylated asparaginase during pediatric acute lymphoblastic leukemia/lymphoma therapy: A side-by-side comparison. Pediatr Blood Cancer. 2024; 71:e30716. https://doi.org/10.1002/pbc.30716