Determination of <span style="font-variant: small-caps">l</span>-Asparaginase Activity and Its Therapeutic Monitoring in Children with Hematological Malignancies in a Single Croatian Center
Background: Among malignant diseases which develop during childhood, hematological cancers, such as leukemias and lymphomas, are the most common. Outcomes have greatly improved due to the refinement of multiagent chemotherapy regimens that include enhanced asparaginase therapy. In this study, we aim...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/6/623 |
| _version_ | 1797241463193468928 |
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| author | Jasna Lenicek Krleza Ana Katusic Bojanac Gordana Jakovljevic |
| author_facet | Jasna Lenicek Krleza Ana Katusic Bojanac Gordana Jakovljevic |
| author_sort | Jasna Lenicek Krleza |
| collection | DOAJ |
| description | Background: Among malignant diseases which develop during childhood, hematological cancers, such as leukemias and lymphomas, are the most common. Outcomes have greatly improved due to the refinement of multiagent chemotherapy regimens that include enhanced asparaginase therapy. In this study, we aimed to evaluate our experiences related to the analytical and clinical significance of determining <span style="font-variant: small-caps;">l</span>-Asparaginase activity. Methods: Since 2016, the Laboratory of the Children’s Hospital Zagreb has routinely measured <span style="font-variant: small-caps;">l</span>-Asparaginase activity and to date, has measured more than 280 examples of activity in a total of 57 children with hematological malignancy treated at the Pediatric Oncology Department of the Children’s Hospital Zagreb. Three asparaginase products were available: native <i>E. coli</i><span style="font-variant: small-caps;">l</span>-Asparaginase; a pegylated form of this enzyme; and a native product from Erwinia chrysanthemi. A retrospective data analysis was performed. Results: Out of the fifty-seven children, seven had an allergic reaction (12.3%), five (8.8%) had silent inactivation, and seven (12.3%) developed acute pancreatitis. Allergic reactions and silent inactivation were more common in children treated with native <i>E. coli</i><span style="font-variant: small-caps;">l</span>-Asparaginase, while pancreatitis was more common in children treated with the pegylated form. Conclusions: The monitoring of <span style="font-variant: small-caps;">l</span>-Asparaginase activity may help to optimize therapy by identifying patients with ‘silent inactivation’, and/or by dose correction when <span style="font-variant: small-caps;">l</span>-Asparaginase activity is too high (slow elimination). |
| first_indexed | 2024-04-24T18:23:43Z |
| format | Article |
| id | doaj.art-9b76adf7917844178cef789ecf640345 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-24T18:23:43Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-9b76adf7917844178cef789ecf6403452024-03-27T13:33:21ZengMDPI AGDiagnostics2075-44182024-03-0114662310.3390/diagnostics14060623Determination of <span style="font-variant: small-caps">l</span>-Asparaginase Activity and Its Therapeutic Monitoring in Children with Hematological Malignancies in a Single Croatian CenterJasna Lenicek Krleza0Ana Katusic Bojanac1Gordana Jakovljevic2Department of Laboratory Diagnostics, Children’s Hospital Zagreb, 10000 Zagreb, CroatiaDepartment of Medical Biology, School of Medicine, University of Zagreb, 10000 Zagreb, CroatiaDepartment of Oncology and Hematology, Children’s Hospital Zagreb, 10000 Zagreb, CroatiaBackground: Among malignant diseases which develop during childhood, hematological cancers, such as leukemias and lymphomas, are the most common. Outcomes have greatly improved due to the refinement of multiagent chemotherapy regimens that include enhanced asparaginase therapy. In this study, we aimed to evaluate our experiences related to the analytical and clinical significance of determining <span style="font-variant: small-caps;">l</span>-Asparaginase activity. Methods: Since 2016, the Laboratory of the Children’s Hospital Zagreb has routinely measured <span style="font-variant: small-caps;">l</span>-Asparaginase activity and to date, has measured more than 280 examples of activity in a total of 57 children with hematological malignancy treated at the Pediatric Oncology Department of the Children’s Hospital Zagreb. Three asparaginase products were available: native <i>E. coli</i><span style="font-variant: small-caps;">l</span>-Asparaginase; a pegylated form of this enzyme; and a native product from Erwinia chrysanthemi. A retrospective data analysis was performed. Results: Out of the fifty-seven children, seven had an allergic reaction (12.3%), five (8.8%) had silent inactivation, and seven (12.3%) developed acute pancreatitis. Allergic reactions and silent inactivation were more common in children treated with native <i>E. coli</i><span style="font-variant: small-caps;">l</span>-Asparaginase, while pancreatitis was more common in children treated with the pegylated form. Conclusions: The monitoring of <span style="font-variant: small-caps;">l</span>-Asparaginase activity may help to optimize therapy by identifying patients with ‘silent inactivation’, and/or by dose correction when <span style="font-variant: small-caps;">l</span>-Asparaginase activity is too high (slow elimination).https://www.mdpi.com/2075-4418/14/6/623asparaginaseasparaginase enzyme activitytherapeutic drug monitoringlymphoblastic malignancychild |
| spellingShingle | Jasna Lenicek Krleza Ana Katusic Bojanac Gordana Jakovljevic Determination of <span style="font-variant: small-caps">l</span>-Asparaginase Activity and Its Therapeutic Monitoring in Children with Hematological Malignancies in a Single Croatian Center Diagnostics asparaginase asparaginase enzyme activity therapeutic drug monitoring lymphoblastic malignancy child |
| title | Determination of <span style="font-variant: small-caps">l</span>-Asparaginase Activity and Its Therapeutic Monitoring in Children with Hematological Malignancies in a Single Croatian Center |
| title_full | Determination of <span style="font-variant: small-caps">l</span>-Asparaginase Activity and Its Therapeutic Monitoring in Children with Hematological Malignancies in a Single Croatian Center |
| title_fullStr | Determination of <span style="font-variant: small-caps">l</span>-Asparaginase Activity and Its Therapeutic Monitoring in Children with Hematological Malignancies in a Single Croatian Center |
| title_full_unstemmed | Determination of <span style="font-variant: small-caps">l</span>-Asparaginase Activity and Its Therapeutic Monitoring in Children with Hematological Malignancies in a Single Croatian Center |
| title_short | Determination of <span style="font-variant: small-caps">l</span>-Asparaginase Activity and Its Therapeutic Monitoring in Children with Hematological Malignancies in a Single Croatian Center |
| title_sort | determination of span style font variant small caps l span asparaginase activity and its therapeutic monitoring in children with hematological malignancies in a single croatian center |
| topic | asparaginase asparaginase enzyme activity therapeutic drug monitoring lymphoblastic malignancy child |
| url | https://www.mdpi.com/2075-4418/14/6/623 |
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