Efficacy and safety of native versus pegylated Escherichia coli asparaginase for treatment of adults with high-risk, Philadelphia chromosome-negative acute lymphoblastic leukemia

Abstract

Native or pegylated (PEG) asparaginase (ASP) are commonly used in treatment of acute lymphoblastic leukemia (ALL), but have been scarcely compared in the same trial in adult patients. Native vs. PEG-ASP administered according to availability in each center were prospectively evaluated in adults with high-risk ALL. Ninety-one patients received native ASP and 35 PEG-ASP in induction. No significant differences were observed in complete remission, minimal residual disease levels after induction and after consolidation, disease-free survival, and overall survival. No significant differences in grades 3–4 toxicity were observed in the induction period, although a trend for higher hepatic toxicity was observed in patients receiving PEG-ASP. In this trial the type of ASP did not influence patient response and outcome.

Keywords:

• Adult acute lymphoblastic leukemia
• Escherichia coli asparaginase
• native
• pegylated
• efficacy
• toxicity

Acknowledgments

We acknowledge the physicians from the following Spanish hospitals participating in this study: Hospital Universitari i Politècnic La Fe, Valencia; Hospital de la Santa Creu i Sant Pau, Barcelona; Hospital Vall d’Hebron, Barcelona; Hospital Universitario de Canarias, Santa Cruz de Tenerife; Hospital Universitario Marqués de Valdecilla, Santander; Hospital Clínico Universitario Virgen de la Victoria, Málaga; Hospital Universitario Virgen del Rocío, Sevilla; ICO-Hospital Germans Trias i Pujol, Badalona; Hospital General de Alicante, Alicante; Hospital del Mar, Barcelona; ICO-Hospital Josep Trueta, Girona; Hospital Universitario Central de Asturias, Oviedo; Hospital Universitario Doce de Octubre, Madrid; Hospital Morales Meseguer, Murcia; ICO-Hospital Duran i Reynals, L’Hospitalet de Llobregat; Hospital Madrid Norte Sanchinarro, Madrid; Hospital Arnau de Vilanova, Valencia; Hospital Mútua Terrassa, Terrassa; Hospital Lucus Augusti, Lugo; Hospital Clínico Universitario, Valladolid; Hospital Ramón y Cajal, Madrid; Complejo Hospitalario Universitario de Ourense, Ourense; Hospital San Pedro de Alcántara, Cáceres; Hospital Son Llàtzer, Palma de Mallorca; Hospital Clínico Universitario, Valencia; Hospital La Zarzuela, Madrid; Hospital General Universitario, Albacete; Hospital Universitario Donostia, San Sebastián; Hospital Universitario de Valme, Sevilla; Hospital Clínico Universitario, Salamanca; Hospital de Fuenlabrada, Fuenlabrada; Hospital Arnau de Vilanova, Lleida; ICO-Hospital Verge de la Cinta, Tortosa; Hospital Infanta Sofía, Madrid; Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2017.1397661.

Additional information

Funding

Supported in part with the grants PI10/01417 from Fondo de Investigaciones Sanitarias and RD12/0036/0029 from RTICC, Instituto de Salud Carlos III, 2014 SGR225(GRE), CERCA Program, Generalitat de Catalunya, Spain, and a funding from ‘La Caixa’ Foundation.