Leukemia & lymphoma/Leukemia and lymphoma · 2017 · 21 citations · 26 references
MedicineOncologyPharmacologyChemotherapyHematologic OncologyHepatotoxicologyChemotherapy In Hematologic MalignanciesChemotherapy Toxicity ManagementHematologic ToxicityHepatotoxicity ManagementToxicity ManagementToxicity Risk AssessmentAcute Lymphoblastic Leukemia TherapyAcute Lymphoblastic Leukemia TreatmentAsparaginase TherapyChemotherapy Toxicity Risk AssessmentComplete Response AssessmentHematologic Toxicity AssessmentMortality RatesMultivariable Regression Analysis
Asparaginase is commonly de-emphasized/omitted in adult acute lymphoblastic leukemia regimens due to poor tolerability, including hepatotoxicity (HTX). Adult patients (n = 100) given induction therapy containing pegylated asparaginase (PEG) from January 2008 to February 2016 were evaluated for HTX. Sixteen patients met criteria for HTX (direct bilirubin >3 g/dL). A multivariable model identified body surface area >2m2 (OR 7.40; 95% CI: 1.73–31.61, p = .007), albumin <3 mg/dL (OR 4.62; 95% CI: 1.09–19.68, p = .038), and platelet count <50 K/mm3 (OR 9.36; 95% CI: 2.13–41.17, p = .003) as risk factors for HTX. More patients with HTX missed ≥1 dose of intended chemotherapy (75% vs. 8%, p < .001). In patients with HTX, complete response and 30-day mortality rates were 40% and 9% versus 73% and 1% in patients without HTX (p = .02 and p < .001). A risk scoring tool was created to predict risk of toxicity, which should be validated through a prospective evaluation.
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Wendy Stock, Mei La, Ben L. Sanford et al. · Blood · 2008 · 533 citations · Full text
Medicine, Oncology, Pediatrics +11
Wendy Stock, Dan Douer, Daniel J. DeAngelo et al. · Leukemia & lymphoma/Leukemia and lymphoma · 2011 · 233 citations