Infusion Technique Reduces AEs in Patients With ALL Receiving PEG-Asparaginase

November 02, 2018

Asparaginase is part of treatment for acute lymphocytic leukemia (ALL) and is associated with improved outcomes in those who complete this course of treatment. Despite the necessity of PEG-asparaginase, 20%–30% of patients can experience toxicities.

Researchers assessed a different infusion technique and observed a statistically and clinically significant reduced rate of adverse events (AEs) in patients receiving PEG-asparaginase with a normal saline infusion compared with those receiving the treatment without fluids. Faina Shenderov, PharmD, BCOP, BCNSP, CNSC, and Anne Schaefer, MD, presented the results in “Study on Prevention of PEG-asparaginase Associated Toxicities” as part of the e-poster sessions on November 2 and 3 during the 2018 JADPRO Live conference in Hollywood, FL.

Researchers conducted a retrospective analysis of 58 patients receiving PEG-asparaginase between September 1, 2014, and July 30, 2017: 37 patients received PEG-asparaginase as an IV piggy-back (IVPB) alone and 21 received PEG-asparaginase through the tubing of a freely infusing solution of normal saline.

AEs occurred in 18.6% of patients receiving PEG-asparaginase IVPB alone and in 1.6% of those receiving it through a running IV line (p = 0.0072). Among those not receiving fluids, four patients experienced grade 3 hypersensitivity during consolidation, one during induction, and one during delayed intensification. Just one patient receiving PEG-asparaginase with normal saline experienced a reaction.

Increased antiemetic use occurred in 18 of 104 IVPB doses (18.4%) compared with one of 64 normal saline doses (1.6%).

The researchers pointed to an improved quality of life and reduced costs with PEG-asparaginase plus normal saline because the use of the more expensive alternative Erwinia asparaginase was avoided.


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