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.

Keywords: L-asparaginaz, çocukluk, akut lenfoblastik lösemi, allerji.