School of Pharmacy, University of Southern California, Los Angeles, CA, USA.
Department of Clinical Pharmacy, School of Pharmacy, Najran University, Najran, Saudi Arabia.
Expert Opin Drug Metab Toxicol. 2023 Jan-Jun;19(6):357-366. doi: 10.1080/17425255.2023.2233412.
Asparaginase is essential to chemotherapy regimens for acute lymphoblastic leukemia (ALL). Survival of patients with ALL has improved since incorporating asparaginase into chemotherapy backbones. Hispanic patients have a higher incidence of ALL than other ethnicities and suffer inferior outcomes. The inferior outcome of Hispanics is due to several factors, including the increased incidence of high-risk genetic subtypes and susceptibility to treatment-related toxicity.
We summarize the current knowledge of asparaginase-related toxicity by comparing their incidence between Hispanic and non-Hispanic patients. These toxicities include hypersensitivity, hepatotoxicity, pancreatitis, thrombosis, and hypertriglyceridemia. The PubMed database and Google Scholar were used to search for this review from October 2022 to June 2023.
Except for hepatotoxicity and hypertriglyceridemia secondary to asparaginase-based treatments, which may develop more frequently among Hispanic patients with ALL, other toxicities were comparable between Hispanic and non-Hispanic patients. Nevertheless, studies with larger cohorts and more accurate capturing of Hispanic ethnicity should be conducted to fill the gaps in the current knowledge.
天冬酰胺酶对于急性淋巴细胞白血病(ALL)的化疗方案至关重要。自从将天冬酰胺酶纳入化疗骨干以来,ALL 患者的生存率有所提高。与其他种族相比,西班牙裔患者 ALL 的发病率更高,且预后更差。西班牙裔患者预后较差的原因有很多,包括高危遗传亚型的发病率增加以及对治疗相关毒性的易感性。
我们通过比较西班牙裔和非西班牙裔患者之间的发病率,总结了与天冬酰胺酶相关的毒性的现有知识。这些毒性包括过敏反应、肝毒性、胰腺炎、血栓形成和高甘油三酯血症。本综述于 2022 年 10 月至 2023 年 6 月期间在 PubMed 数据库和 Google Scholar 上搜索。
除了基于天冬酰胺酶治疗的肝毒性和高甘油三酯血症可能在 ALL 的西班牙裔患者中更频繁地发生外,其他毒性在西班牙裔和非西班牙裔患者之间相当。然而,应该进行具有更大队列和更准确捕捉西班牙裔种族的研究,以填补当前知识的空白。