School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Leuk Lymphoma. 2022 Dec;63(12):2948-2954. doi: 10.1080/10428194.2022.2102621. Epub 2022 Jul 27.
A total of 548 patients (age range: 1-22 years, 60.4% Hispanic, 55.8% male) diagnosed with acute lymphoblastic leukemia were reviewed for pegaspargase-associated hypersensitivity (14.8%), hyperbilirubinemia (9.7%), venous thromboembolism (VTE, 9.7%), and pancreatitis (5.3%). Odds ratios (OR) and 95% confidence intervals (CI) evaluated associations between clinical factors and each toxicity, cumulative number of toxicities, and toxicity clusters identified using k-mode analysis. Most (68.9%) did not experience any toxicity, 24.6% experienced one toxicity, and 6.3% two or more. Age >10 years was associated with hyperbilirubinemia (OR = 3.83; 95% CI: 1.64-8.95), pancreatitis (OR = 3.72; 95% CI: 1.29-10.68), VTE (OR = 4.65; 95% CI: 1.96-11.02), and cumulative toxicity burden (OR = 3.28, 95% CI: 1.97-5.47); high-risk therapy with hypersensitivity (OR 2.25; 95% CI 1.25-4.05); and overweight with cumulative toxicity burden (OR = 1.76, 95% CI: 1.20-2.57). Eight unique toxicity profiles were identified. Older age, overweight, and treatment intensity contribute to pegaspargase-associated toxicities.
共有 548 名（年龄范围：1-22 岁，60.4%为西班牙裔，55.8%为男性）被诊断为急性淋巴细胞白血病的患者接受了培门冬酶相关过敏反应（14.8%）、高胆红素血症（9.7%）、静脉血栓栓塞症（VTE，9.7%）和胰腺炎（5.3%）的评估。采用 k-均值分析评估了临床因素与每种毒性、累积毒性数以及毒性簇之间的关联。大多数（68.9%）患者没有发生任何毒性，24.6%的患者发生了 1 种毒性，6.3%的患者发生了 2 种或更多毒性。年龄＞10 岁与高胆红素血症（OR=3.83；95%CI：1.64-8.95）、胰腺炎（OR=3.72；95%CI：1.29-10.68）、VTE（OR=4.65；95%CI：1.96-11.02）和累积毒性负担（OR=3.28，95%CI：1.97-5.47）相关；高风险治疗伴过敏反应（OR=2.25；95%CI 1.25-4.05）；超重与累积毒性负担（OR=1.76，95%CI：1.20-2.57）相关。确定了 8 种独特的毒性特征。年龄较大、超重和治疗强度是培门冬酶相关毒性的原因。
