Relapse risk following truncation of PEG-asparaginase in childhood acute lymphoblastic leukemia.

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Fältnamn	Indikatorer	Metadata
000		04172naa a2200493 4500
001		oai:gup.ub.gu.se/299419
003		SwePub
008		240528s2021 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
009		oai:prod.swepub.kib.ki.se:146620484
024	7	a https://gup.ub.gu.se/publication/2994192 URI
024	7	a https://doi.org/10.1182/blood.20200065832 DOI
024	7	a http://kipublications.ki.se/Default.aspx?queryparsed=id:1466204842 URI
040		a (SwePub)gud (SwePub)ki
041		a eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Gottschalk Højfeldt, Sofie4 aut
245	1 0	a Relapse risk following truncation of PEG-asparaginase in childhood acute lymphoblastic leukemia.
264	1	b American Society of Hematology,c 2021
520		a Truncation of asparaginase treatment due to asparaginase related toxicities or silent inactivation (SI) is common and may increase relapse risk in acute lymphoblastic leukemia (ALL). We investigated relapse risk following suboptimal asparaginase exposure among 1401 children aged 1-17 years, diagnosed with ALL between July 2008 and February 2016, and treated according to the NOPHO ALL2008 protocol including extended asparaginase exposure (1,000 IU/m2 intramuscularly weeks 5 to 33). Patients were included with delayed entry at their last administered asparaginase treatment or detection of SI and followed until relapse, death, secondary malignancy, or end of follow-up (median: 5.71 years, interquartile range: 4.02-7.64). In a multiple Cox model comparing patients with (n=358) and without (n=1043) truncated asparaginase treatment due to clinical toxicity, the adjusted relapse-specific hazard ratio (aHR) was 1.33 (95% confidence interval [CI]: 0.86-2.06, P=0.20). In a substudy including only patients with information on enzyme activity (n=1115), the 7-year cumulative incidence of relapse for the 301 patients with truncation of asparaginase treatment or SI (157 hypersensitivity, 53 pancreatitis, 14 thrombosis, 31 other, 46 SI) was 11.1% (95% CI: 6.9-15.4) versus 6.7% (95% CI: 4.7-8.6) for the 814 remaining patients. The relapse-specific aHR was 1.69 (95% CI: 1.05-2.74, P=0.03). The unadjusted bone-marrow relapse-specific HR was 1.83 (95% CI: 1.07-3.14, P=0.03) and 1.86 (95% CI: 0.90- 3.87, P=0.095) for any CNS relapse. These results emphasize the importance of therapeutic drug monitoring and appropriate adjustment of asparaginase therapy when feasible.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Pediatrik0 (SwePub)302212 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Pediatrics0 (SwePub)302212 hsv//eng
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Cancer och onkologi0 (SwePub)302032 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cancer and Oncology0 (SwePub)302032 hsv//eng
700	1	a Grell, Kathrine4 aut
700	1	a Abrahamsson, Jonas,d 1954u Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics4 aut0 (Swepub:gu)xabrjo
700	1	a Lund, Bendik4 aut
700	1	a Vettenranta, Kim4 aut
700	1	a Jonsson, Olafur G4 aut
700	1	a Frandsen, Thomas Leth4 aut
700	1	a Wolthers, Benjamin Ole4 aut
700	1	a Marquart, Hanne Vibeke Hansen4 aut
700	1	a Vaitkeviciene, Goda4 aut
700	1	a Lepik, Kristi4 aut
700	1	a Heyman, Matsu Karolinska Institutet4 aut
700	1	a Schmiegelow, Kjeld4 aut
700	1	a Albertsen, Birgitte Klug4 aut
710	2	a Göteborgs universitetb Institutionen för kliniska vetenskaper, Avdelningen för pediatrik4 org
773	0	t Bloodd : American Society of Hematologyg 137:17, s. 2373-2382q 137:17<2373-2382x 1528-0020x 0006-4971
856	4	u https://helda.helsinki.fi/bitstream/10138/336002/1/Relapse_risk_following_truncation_of_PEG_asparaginase.pdf
856	4 8	u https://gup.ub.gu.se/publication/299419
856	4 8	u https://doi.org/10.1182/blood.2020006583
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:146620484

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By the author/editor: Gottschalk Højfe ...; Grell, Kathrine; Abrahamsson, Jon ...; Lund, Bendik; Vettenranta, Kim; Jonsson, Olafur ...; show more...; Frandsen, Thomas ...; Wolthers, Benjam ...; Marquart, Hanne ...; Vaitkeviciene, G ...; Lepik, Kristi; Heyman, Mats; Schmiegelow, Kje ...; Albertsen, Birgi ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Pediatrics

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

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