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L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study

BACKGROUND: The survival of children with acute lymphoblastic leukemia (ALL) has improved due to changes in the treatment and the disease diagnosis. A significant advance was the incorporation of asparaginase. However, hypersensitivity reactions are a common cause of early discontinuation of this dr...

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Autores principales: dos Santos, Amanda Cabral, dos Santos, Julia Maria Bispo, da Costa Lima, Elisangela, Land, Marcelo Gerardin Poirot
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9351670/
https://www.ncbi.nlm.nih.gov/pubmed/34431241
http://dx.doi.org/10.1002/cnr2.1533
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author dos Santos, Amanda Cabral
dos Santos, Julia Maria Bispo
da Costa Lima, Elisangela
Land, Marcelo Gerardin Poirot
author_facet dos Santos, Amanda Cabral
dos Santos, Julia Maria Bispo
da Costa Lima, Elisangela
Land, Marcelo Gerardin Poirot
author_sort dos Santos, Amanda Cabral
collection PubMed
description BACKGROUND: The survival of children with acute lymphoblastic leukemia (ALL) has improved due to changes in the treatment and the disease diagnosis. A significant advance was the incorporation of asparaginase. However, hypersensitivity reactions are a common cause of early discontinuation of this drug. AIM: The proposed study aims to evaluate early interruptions and the influence of the number of asparaginase doses effectively administered on the prognosis of patients with ALL. METHODS AND RESULTS: An observational cohort study was carried out, with retrospective data collection, in medical records. The prognostic variables indicated in the protocol applied were used, and the principal outcomes were 5 years event‐free survival (EFS) and 5 years of overall survival (OS) probability. Statistical analyzes were performed using SPPS 20.0 and R. In Cox's proportional hazards model for EFS and OS, variables of prognostic importance (n = 126 children) were: high‐risk group (HGR), by the protocol classification, and less than 10 doses of asparaginase. The increased risk of events and death in HGR, who did less than 10 doses, was 3.6 and 7 times, respectively. The study did not show statistical significance for the number of asparaginase doses in patients who were not at high risk. CONCLUSIONS: We demonstrated that the early interruption of asparaginase treatment could negatively impact the prognosis of patients with ALL, especially HGR, reinforcing the need for careful diagnosis of reactions and the availability of alternative types of asparaginase.
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spelling pubmed-93516702022-08-09 L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study dos Santos, Amanda Cabral dos Santos, Julia Maria Bispo da Costa Lima, Elisangela Land, Marcelo Gerardin Poirot Cancer Rep (Hoboken) Original Articles BACKGROUND: The survival of children with acute lymphoblastic leukemia (ALL) has improved due to changes in the treatment and the disease diagnosis. A significant advance was the incorporation of asparaginase. However, hypersensitivity reactions are a common cause of early discontinuation of this drug. AIM: The proposed study aims to evaluate early interruptions and the influence of the number of asparaginase doses effectively administered on the prognosis of patients with ALL. METHODS AND RESULTS: An observational cohort study was carried out, with retrospective data collection, in medical records. The prognostic variables indicated in the protocol applied were used, and the principal outcomes were 5 years event‐free survival (EFS) and 5 years of overall survival (OS) probability. Statistical analyzes were performed using SPPS 20.0 and R. In Cox's proportional hazards model for EFS and OS, variables of prognostic importance (n = 126 children) were: high‐risk group (HGR), by the protocol classification, and less than 10 doses of asparaginase. The increased risk of events and death in HGR, who did less than 10 doses, was 3.6 and 7 times, respectively. The study did not show statistical significance for the number of asparaginase doses in patients who were not at high risk. CONCLUSIONS: We demonstrated that the early interruption of asparaginase treatment could negatively impact the prognosis of patients with ALL, especially HGR, reinforcing the need for careful diagnosis of reactions and the availability of alternative types of asparaginase. John Wiley and Sons Inc. 2021-08-24 /pmc/articles/PMC9351670/ /pubmed/34431241 http://dx.doi.org/10.1002/cnr2.1533 Text en © 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
dos Santos, Amanda Cabral
dos Santos, Julia Maria Bispo
da Costa Lima, Elisangela
Land, Marcelo Gerardin Poirot
L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study
title L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study
title_full L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study
title_fullStr L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study
title_full_unstemmed L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study
title_short L‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: A survival analysis study
title_sort l‐asparaginase doses number as a prognostic factor in childhood acute lymphoblastic leukemia: a survival analysis study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9351670/
https://www.ncbi.nlm.nih.gov/pubmed/34431241
http://dx.doi.org/10.1002/cnr2.1533
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