期刊
EUROPEAN JOURNAL OF CANCER
卷 157, 期 -, 页码 238-249出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2021.08.025
关键词
Acute lymphoblastic leukaemia; Asparaginase; Dose intensity; Pediatric ALL; Outcome
类别
资金
- Jazz Pharmaceuticals
This review evaluates the optimal amount of asparaginase needed for childhood ALL treatment outcomes. While the level of exposure does not impact the outcome as long as therapeutic asparaginase activity levels are reached, the duration of exposure does have an effect on the outcome, with no clear cutoff for optimal exposure duration established. Other factors such as immunophenotype, (cyto)genetic subgroups, risk group stratification, and backbone therapy also influence the optimal exposure duration.
This review focuses on asparaginase, a key component of childhood acute lymphoblastic leukaemia (ALL) treatment since the 1970s. This review evaluates how much asparaginase is needed for optimal outcome in childhood ALL. We provide an overview of asparaginase dose intensity, i.e. duration of total cumulative exposure in weeks and level of exposure reflected by dose and/or asparaginase activity level, and the corresponding outcome. We systematically searched papers published between January 1990 and March 2021 in the PubMed and MEDLINE databases and included 20 papers. The level and duration of exposure were based on the pharmacokinetic profile of the drug and the assumption that trough asparaginase activity levels of >= 100 IU/L should be achieved for complete L-asparagine depletion. The statistical meta-analysis of outcomes was not performed because different outcome measures were used. The level of exposure was not associated with the outcome as long as therapeutic asparaginase activity levels of >= 100 IU/L were reached. Conflicting results were found in the randomised controlled trials, but all truncation studies showed that the duration of exposure (expressed as weeks of L-asparagine depletion) does affect the outcome; however, no clear cutoff for optimal exposure duration was determined. Optimal exposure duration will also depend on immunophenotype, (cyto)genetic subgroups, risk group stratification and backbone therapy. (C) 2021 Published by Elsevier Ltd.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据