Browne Emily K, Moore Christina, Sykes April, Lu Zhaohua, Jeha Sima, Mandrell Belinda N
St. Jude Children's Research Hospital, Memphis, TN, USA.
J Pediatr Oncol Nurs. 2018 Mar/Apr;35(2):103-109. doi: 10.1177/1043454217741868. Epub 2017 Nov 21.
Asparaginase poses a substantial risk for hypersensitivity reactions during and after administration; however, these reactions vary by asparaginase formulation and administration route. It is imperative that nurses be knowledgeable of clinical symptoms associated with intravenous (IV) monomethoxypolyethylene glycol (PEG)-asparaginase reactions, as well as potential reaction timing.
This single institution retrospective study describes the clinical factors among patients with IV PEG-asparaginase hypersensitivity reactions.
Reaction frequency and severity, dose, phase of treatment, and time between infusion initiation and reaction were collected on patients identified as having an IV PEG-asparaginase hypersensitivity reaction while undergoing acute lymphoblastic leukemia treatment.
Sixty-three patients (12.8%) developed a hypersensitivity reaction to IV PEG-asparaginase, with the reaction occurring during a median of 3 doses in both risk arms. Reactions were noted ≤60 minutes after infusion initiation in 98% of patients, and no reactions were fatal.
Nurses should carefully observe patients throughout the infusion and anticipate adverse reactions, particularly during the first 3 doses and first 10 minutes of each infusion. Patient and family education should include the rare risk of delayed reactions.
天冬酰胺酶在给药期间及之后会引发严重的过敏反应风险；然而，这些反应因天冬酰胺酶制剂和给药途径而异。护士必须了解与静脉注射（IV）单甲氧基聚乙二醇（PEG）-天冬酰胺酶反应相关的临床症状以及潜在的反应时间。
这项单机构回顾性研究描述了IV PEG-天冬酰胺酶过敏反应患者的临床因素。
收集了在接受急性淋巴细胞白血病治疗期间被确定为发生IV PEG-天冬酰胺酶过敏反应的患者的反应频率和严重程度、剂量、治疗阶段以及从输液开始到反应发生的时间。
63名患者（12.8%）对IV PEG-天冬酰胺酶发生过敏反应，两个风险组中反应均在中位3剂时出现。98%的患者在输液开始后≤60分钟出现反应，且无反应导致死亡。
护士应在整个输液过程中仔细观察患者，并预期不良反应，尤其是在前3剂以及每次输液的前10分钟。对患者及其家属的教育应包括延迟反应的罕见风险。
