Çocuk Sağlığı ve Hastalıkları Dergisi 2011 , Vol 54 , Num 4
Incidence of allergic reactions due to L-asparaginase during therapy of children with acute lymphoblastic leukemia and approach to allergic reactions
*Gamze Gençalp1, Betül Tavil3, Lale Olcay2
Dr. Abdurrahman Yurtaslan, Ankara Onkoloji Eğitim ve Araştırma Hastanesi 1Pediatrik Hematoloji Hemşiresi, 2Pediatrik Hematoloji Doçenti, 3Pediatrik Hematoloji Uzmanı The aim of this study was to examine allergic reactions due to L-asparaginase (L-Asp). L-Asp administrations in our acute lymphoblastic leukemia patients were evaluated retrospectively. Twenty-seven (10.4%) acute allergic reaction and mild-moderate anaphylaxis (10.4%) and no severe anaphylaxis developed in 260 administrations. Allergy developed in 15.9% (19/119) and 5.6% (8/141) of patients who were treated via intravenous (IV) and intramuscular (IM) routes (p<0.05), accounting for 54.2% and 45.8% of all administrations, respectively. IV and IM routes were used in 70.4% and 29.6% of those with allergic reactions (p<0.05). Allergic reactions decreased in patients who received the drug after IV was changed to IM route. Our allergy incidence (10.4%) was less than that in the literature (35%) and similar to that after polyethylene glycol (PEG)-asparaginase (10%). Allergy premedication was performed in 89.2% (232/260) of all administrations. Allergic reactions were encountered in 10.8% (25/232) of the premedicated patients. Among the premedicated patients, allergy was established in 17.1% (20/117) of IV administrations and 4.3% (5/115) of IM administrations (p<0.05). Allergy risk can be reduced by allergic premedication and preference of IM route, so that the need for PEG-asparaginase, which is less allergenic but not available in our country, can be abolished. Anahtar Kelimeler : L-asparaginaz, çocukluk, akut lenfoblastik lösemi, allerji.
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