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2. Genetic ancestry and skeletal toxicities among childhood acute lymphoblastic leukemia patients in the DFCI 05-001 cohort

Author

Yao, Song, Zhu, Qianqian, Cole, Peter D., Stevenson, Kristen, Harris, Marian H., Schultz, Emily, Kahn, Justine M., Ladas, Elena J., Athale, Uma H., Clavell, Luis A., Laverdiere, Caroline, Leclerc, Jean-Marie, Michon, Bruno, Schorin, Marshall A., Welch, Jennifer J.G., Sallan, Stephen E., Silverman, Lewis B., and Kelly, Kara M.

Published
2021
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8. Blinatumomab Is Cost-Effective Compared to Standard Chemotherapy for Children with High Risk Relapses of Acute Lymphoblastic Leukemia: A Cost-Effectiveness Analysis Using Population-Based Healthcare Data

Author

Pechlivanoglou, Petros, primary, Luu, Linda, additional, Li, Qing, additional, Gibson, Paul J., additional, Athale, Uma H., additional, Bassal, Mylene, additional, Breakey, Vicky R., additional, Patel, Serina, additional, Pole, Jason, additional, Sutradhar, Rinku, additional, Wheaton, Laura, additional, Mittmann, Nicole, additional, and Gupta, Sumit, additional

Published
2021
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9. Rates and Predictors of Visits to Primary Care Physicians during and after Treatment of Childhood Acute Lymphoblastic Leukemia: A Population-Based Cohort Study

Author

Breakey, Vicky R., primary, Nathan, Paul, additional, Patel, Serina, additional, Wheaton, Laura, additional, Li, Qing, additional, Sutradhar, Rinku, additional, Bassal, Mylene, additional, Gibson, Paul J., additional, Pole, Jason, additional, Athale, Uma H., additional, and Gupta, Sumit, additional

Published
2021
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10. Impact of Age, Body Surface Area, and Body Mass Index on Pegaspargase Toxicity and Pharmacokinetics: A Report from the DFCI ALL Consortium

Author

Paolino, Jonathan D., primary, Flamand, Yael, additional, Stevenson, Kristen E., additional, Koch, Victoria, additional, Athale, Uma H., additional, Cole, Peter D., additional, Gennarini, Lisa M., additional, Kahn, Justine M., additional, Kelly, Kara M., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Place, Andrew E., additional, Supko, Jeffrey G., additional, Tran, Thai Hoa, additional, Welch, Jennifer J.G., additional, Neuberg, Donna S., additional, Sallan, Stephen E., additional, Silverman, Lewis B., additional, and Vrooman, Lynda M., additional

Published
2021
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12. Frequency and Prognostic Significance of Recurrent Gene Mutations in Pediatric B-ALL: Report from the DFCI ALL Consortium

Author

Gotti, Giacomo, primary, Puligandla, Maneka, additional, Stevenson, Kristen E., additional, Mar, Brenton G., additional, Asselin, Barbara L, additional, Athale, Uma, additional, Clavell, Luis A., additional, Cole, Peter D., additional, Gennarini, Lisa M., additional, Kahn, Justine M., additional, Kelly, Kara M., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Sulis, Maria L., additional, Tran, Thai Hoa, additional, Welch, Jennifer J.G., additional, Stegmaier, Kimberly, additional, Harris, Marian H., additional, Silverman, Lewis B., additional, and Pikman, Yana, additional

Published
2020
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14. Healthcare Utilization and Costs Associated with Different Treatment Protocols for Newly Diagnosed Childhood Acute Lymphoblastic Leukemia: A Population-Based Study

Author

Gupta, Sumit, primary, Mittman, Nicole, additional, Pechlivanoglou, Petros, additional, Li, Qing, additional, Athale, Uma, additional, Bassal, Mylene, additional, Breakey, Vicky R., additional, Gibson, Paul J., additional, Silva, Mariana, additional, Zabih, Veda, additional, Pole, Jason, additional, and Sutradhar, Rinku, additional

Published
2020
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16. Genetic Ancestry and Skeletal Toxicities Among Childhood Acute Lymphoblastic Leukemia Patients in the DFCI 05-001 Cohort

Author

Zhu, Qianqian, primary, Yao, Song, additional, Cole, Peter D, additional, Kahn, Justine M., additional, Harris, Marian H., additional, Schiller, Emily, additional, Athale, Uma, additional, Clavell, Luis A., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Welch, Jennifer J.G., additional, Sallan, Stephen E., additional, Silverman, Lewis B., additional, and Kelly, Kara M., additional

Published
2019
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17. Do children with central venous line (CVL) dysfunction have increased risk of symptomatic thromboembolism compared to those without CVL-dysfunction, while on cancer therapy?

Author

Halton Jacqueline, Nagel Kim, Brandão Leonardo R, Silva Mariana, Gibson Paul, Chan Anthony, Blyth Kay, Hicks Kim, Parmar Nagina, Paddock Leslie, Willing Stephanie, Thabane Lehana, and Athale Uma

Subjects
Central venous line, Central venous line dysfunction, Infection, Thromboembolism, Cancer, Children, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background Thromboembolism (TE) and infection are two common complications of central venous line (CVL). Thrombotic CVL-dysfunction is a common, yet less studied, complication of CVL. Two retrospective studies have reported significant association of CVL-dysfunction and TE. Recent studies indicate association of CVL-related small clot with infection. Infection is the most common cause of non-cancer related mortality in children with cancer. We and others have shown reduced overall survival (OS) in children with cancer and CVL-dysfunction compared to those without CVL-dysfunction. Despite these observations, to date there are no prospective studies to evaluate the clinical significance of CVL-dysfunction and it’s impact on the development of TE, infection, or outcome of children with cancer. Study design This is a prospective, analytical cohort study conducted at five tertiary care pediatric oncology centers in Ontario. Children (≤ 18 years of age) with non-central nervous system cancers and CVL will be eligible for the study. Primary outcome measure is symptomatic TE and secondary outcomes are infection, recurrence of cancer and death due to any cause. Data will be analyzed using regression analyses. Discussion The overall objective is to delineate the relationship between CVL-dysfunction, infection and TE. The primary aim is to evaluate the role of CVL-dysfunction as a predictor of symptomatic TE in children with cancer. We hypothesize that children with CVL-dysfunction have activation of the coagulation system resulting in an increased risk of symptomatic TE. The secondary aims are to study the impact of CVL-dysfunction on the rate of infection and the survival [OS and event free survival (EFS)] of children with cancer. We postulate that patients with CVL-dysfunction have an occult CVL-related clot which acts as a microbial focus with resultant increased risk of infection. Further, CVL-dysfunction by itself or in combination with associated complications may cause therapy delays resulting in adverse outcome. This study will help to identify children at high risk for TE and infection. Based on the study results, we will design randomized controlled trials of prophylactic anticoagulant therapy to reduce the incidence of TE and infection. This in turn will help to improve the outcome in children with cancer.

Published
2012
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18. Evaluating the endometabolic and bone health effects of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukaemia: a systematic review protocol

Author

Balakumaran, Janatani, primary, Birk, Tanisha, additional, Golemiec, Breanne, additional, Helmeczi, Wryan, additional, Inkaran, Jeyanth, additional, Kao, Yun-ya, additional, Leigh, Jennifer, additional, Saliba, Sarah, additional, Sharma, Rishi, additional, Spatafora, Laura, additional, Wright, Kristin, additional, Yao, William, additional, Hillis, Christopher, additional, Banfield, Laura, additional, Thabane, Lehana, additional, Athale, Uma, additional, and Samaan, M Constantine, additional

Published
2019
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19. High Vs. Low-Intensity Bridging Chemotherapy in Children with Acute Lymphoblastic Leukemia Awaiting Chimeric Antigen Receptor T-Cell Therapy: A Population-Based Study from Ontario, Canada

Author

Gupta, Sumit, primary, Alexander, Sarah, additional, Zupanec, Sue, additional, Athale, Uma, additional, Bassal, Mylene, additional, Edwards, Ethan, additional, Gibson, Paul J., additional, Johnston, Donna, additional, Marjerrison, Stacey, additional, Zorzi, Alexander, additional, Hitzler, Johann K., additional, Naqvi, Ahmed, additional, Punnett, Angela, additional, Whitlock, James A., additional, Grupp, Stephan A., additional, Maude, Shannon L., additional, and Krueger, Joerg, additional

Published
2018
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21. Increasing Incidence and Prevalence of Pathologic Hemoglobinopathies Among Children in Ontario, Canada from 1991-2013

Author

Simpson, Ewurabena, primary, Klaassen, Robert J, additional, Chakraborty, Pranesh, additional, Potter, Beth, additional, Kirby-Allen, Melanie Ann, additional, Odame, Isaac, additional, Williams, Suzan, additional, Athale, Uma, additional, Jardine, Lawrence, additional, Gibson, Paul J., additional, Silva, Mariana, additional, Merelles-Pulcini, Manuela, additional, Bowerman, Brooke, additional, Petrcich, William, additional, and Benchimol, Eric I, additional

Published
2018
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23. Influence of HIV epidemic on the incidence of Kaposi's sarcoma in Zambian children

Author

Athale, Uma H., Patil, P.S., Chintu, C., and Elem, B.

Subjects
Zambia -- Health aspects, Kaposi's sarcoma -- Demographic aspects, HIV infection -- Complications, Health
Abstract

The incidence of Kaposi's sarcoma in Zambian children has increased dramatically since 1981. Researchers reviewed the records of all pediatric KS cases seen at Zambia's University Teaching Hospital since 1981. In that period, the hospital recorded 85 pediatric KS cases. There were no cases in 1981, but the number of cases gradually increased, especially after 1987. Before 1986, pediatric KS represented six percent of all childhood cancers on average. Between 1987 and 1992, it averaged 19% of all childhood cancers. More than half of the children with KS were less than five years old. In almost 79% of the cases, the primary lesion was in the lymph nodes. The average survival following diagnosis was 13 weeks.

Published
1995

25. Refining risk classification in childhood B acute lymphoblastic leukemia: results of DFCI ALL Consortium Protocol 05-001

Author

Vrooman, Lynda M., primary, Blonquist, Traci M., additional, Harris, Marian H., additional, Stevenson, Kristen E., additional, Place, Andrew E., additional, Hunt, Sarah K., additional, O’Brien, Jane E., additional, Asselin, Barbara L., additional, Athale, Uma H., additional, Clavell, Luis A., additional, Cole, Peter D., additional, Kelly, Kara M., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Sulis, Maria Luisa, additional, Welch, Jennifer J. G., additional, Neuberg, Donna S., additional, Sallan, Stephen E., additional, and Silverman, Lewis B., additional

Published
2018
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26. Prognostic impact of kinase-activating fusions and IKZF1 deletions in pediatric high-risk B-lineage acute lymphoblastic leukemia

Author

Tran, Thai Hoa, primary, Harris, Marian H., additional, Nguyen, Jonathan V., additional, Blonquist, Traci M., additional, Stevenson, Kristen E., additional, Stonerock, Eileen, additional, Asselin, Barbara L., additional, Athale, Uma H., additional, Clavell, Luis A., additional, Cole, Peter D., additional, Kelly, Kara M., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Welch, Jennifer J. G., additional, Reshmi, Shalini C., additional, Neuberg, Donna S., additional, Sallan, Stephen E., additional, Loh, Mignon L., additional, and Silverman, Lewis B., additional

Published
2018
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27. CARDIOVASCULAR SIGNALING PROTEINS AS PREDICTORS OF DOXORUBICIN-RELATED CARDIAC EFFECTS IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA

Author

Lipshultz, Steven, primary, Blonquist, Traci M., additional, Miller, Tracie L., additional, Neuberg, Donna S., additional, Smith, Holly M., additional, Anderson, Brent, additional, Franco, Vivian I., additional, Bansal, Neha, additional, Lipshultz, Emma R., additional, Scully, Rebecca E., additional, Silverman, Lewis B., additional, Colan, Steven D., additional, Asselin, Barbara L., additional, Athale, Uma, additional, Clavell, Luis A., additional, Laverdiere, Caroline, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Sallan, Stephen E., additional, and Sawyer, Douglas, additional

Published
2018
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30. Outcome of acute Myeloid Leukemia in Adults Patients Treated According to Morocco National AML-MA-2011 Protocol in Casablanca, Morocco

Author

Massi, Romaric, primary, Lamchahab, Mouna, additional, Bencharef, Hanaa, additional, Houssou, Bienvenu, additional, Khoubila, Nisrine, additional, Cherkoui, Siham, additional, Qachouh, Meryem, additional, Rachid, Mohamed, additional, Madani, Abdallah, additional, Athale, Uma H., additional, and Quessar, Asmaa AQ, additional

Published
2016
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33. Excellent Outcome of Children with Down Syndrome (DS) and Acute Lymphoblastic Leukemia (ALL) Treated on Dana-Farber Cancer Institute (DFCI) ALL Consortium Protocols 00-001 and 05-001

Author

Athale, Uma H., primary, Puligandla, Maneka, additional, Stevenson, Kristen E., additional, Asselin, Barbara L., additional, Clavell, Luis A., additional, Cole, Peter D., additional, Kelly, Kara M., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Sulis, Maria Luisa, additional, Welch, Jennifer J.G., additional, Harris, Marian H., additional, Neuberg, Donna S., additional, Sallan, Stephen E., additional, and Silverman, Lewis B., additional

Published
2016
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36. Kinase-Activating Fusions in Pediatric High-Risk B-Lineage Acute Lymphoblastic Leukemia (ALL): a Report from the Dana-Farber Cancer Institute (DFCI) ALL Consortium

Author

Tran, Thai Hoa, primary, Harris, Marian H., additional, Nguyen, Jonathan V., additional, Blonquist, Traci M., additional, Stevenson, Kristen E., additional, Stonerock, Eileen, additional, Asselin, Barbara L., additional, Athale, Uma H., additional, Clavell, Luis A., additional, Cole, Peter D., additional, Kelly, Kara M., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Welch, Jennifer J.G., additional, Reshmi, Shalini C., additional, Neuberg, Donna S., additional, Sallan, Stephen E., additional, Loh, Mignon L., additional, and Silverman, Lewis B., additional

Published
2016
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37. Randomized Study of Pegasparagase (SS-PEG) and Calaspargase Pegol (SC-PEG) in Pediatric Patients with Newly Diagnosed Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma: Results of DFCI ALL Consortium Protocol 11-001

Author

Silverman, Lewis B., primary, Blonquist, Traci M., additional, Hunt, Sarah K., additional, Kay-Green, Samantha, additional, Athale, Uma H., additional, Clavell, Luis A., additional, Cole, Peter D., additional, Kelly, Kara M., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Sulis, Maria Luisa, additional, Welch, Jennifer J.G., additional, Supko, Jeffrey G., additional, He, Xiaoyong, additional, Hilderbrand, Sarah, additional, Place, Andrew E., additional, Vrooman, Lynda M., additional, Harris, Marian H., additional, Stevenson, Kristen E., additional, Neuberg, Donna S., additional, and Sallan, Stephen E., additional

Published
2016
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38. Outcome of Infants Treated on Total Therapy for Infants with Acute Lymphoblastic Leukemia I: Results from a Non-Randomized Multi-Center Study

Author

Gruber, Tanja A., Huang, Minxuan, Jeha, Sima, Deyell, Rebecca J., Lewis, Victor A., Chang, Bill H., Lowe, Eric J., Frediani, Jamie, Vezina, Catherine, Michon, Bruno, Gossai, Nathan, Breese, Erin H., Tran, Thai Hoa, Lacayo, Norman J., Bolen, Christine, Desai, Sunil J., Pauley, Jennifer L., Ashcraft, Emily, Cheng, Cheng, Schultz, Kirk R., Schils, Krysta, Stork, Linda C., Huynh, Van Thu, Richards, Michael, Messinger, Yoav H., Bittencourt, Henrique, Horton, Terzah M., Athale, Uma, Stearns, Duncan, Schiff, Deborah E., and Gaynon, Paul S.

Abstract

Infants with KMT2A rearranged (KMT2Ar) acute lymphoblastic leukemia (ALL) have a poor prognosis with an event-free-survival (EFS) of 33.6-36.9% on recent Children's Oncology Group and Interfant trials. In preclinical studies, we identified bortezomib and vorinostat as novel active agents in primary KMT2Ar infant ALL specimens that have not been included in infant regimens to date. Total therapy for infants with acute lymphoblastic leukemia I (TINI) evaluated this novel combination in a multi-institutional pilot trial for infants with de novoALL. In this study, bortezomib and vorinostat were incorporated into an ALL chemotherapy backbone containing dexamethasone, mitoxantrone, and pegasparaginase during induction and reinduction chemotherapy cycles. A run-in dose escalation evaluated 3 dose levels of vorinostat which was then followed by a dose expansion phase. The primary endpoint of the study was tolerability; secondary endpoints included minimal residual disease (MRD), 3-year EFS and overall survival (OS). Fifty patients enrolled between 2017-2021. Median follow up was 3.4 years (range 1.6-6.8 years). The six patients in the dose escalation phase had no dose-limiting toxicities. Forty-four patients received vorinostat at the third dose level (DL3) of 180 mg/m 2/dose. 68% of patients treated at DL3 had CNS involvement at diagnosis. 68% of DL3 patients carried a KMT2Ar. The most frequent KMT2A partner genes were AFF1 (40%), MLLT1 (20%), and MLLT3 (13%). The most frequent grade 3-4 non-hematologic adverse events during induction include neutropenic fever (45%), hypertension (43%), infection (40%), anorexia (32%), diarrhea (18%) and perineal skin ulceration (16%). There were 3 episodes of sepsis and 1 induction death due to parainfluenza pneumonia. Fewer events and no deaths or proven sepsis occurred during reinduction, with only grade 3 hypertriglyceridemia exceeding 10% of patients affected (18%). 79% of all patients and 69% of KMT2Ar patients became MRD negative by flow cytometry on day 22 of induction following our investigational block. Following induction intensification with cyclophosphamide, cytarabine, and mercaptopurine, 77% and 66% of all patients and KMT2Ar patients respectively were MRD negative at the time of count recovery. Eight of the forty-four patients, all KMT2Ar, underwent stem cell transplant in first remission due to persistent MRD positivity at the end of consolidation.

Published
2023
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39. Higher Incidence of Treatment-Related Toxicities in Non-Hispanic Patients Undergoing Therapy for Newly Diagnosed Pediatric Acute Lymphoblastic Leukemia on Dana-Farber Cancer Institute ALL Consortium Protocol 05-001

Author

Kahn, Justine, primary, Barrera, Sergio, additional, Davila, Randy, additional, Roberts, Emily, additional, Jin, ZheZhen, additional, Stevenson, Kristen, additional, Blonquist, Traci M., additional, Neuberg, Donna S, additional, Athale, Uma H., additional, Clavell, Luis A., additional, Cole, Peter, additional, Laverdiere, Caroline, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Welch, Jennifer J.G., additional, Sallan, Stephen E., additional, Silverman, Lewis B., additional, and Kelly, Kara M., additional

Published
2015
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40. Ikaros Gene Deletion Significantly Predicts Relapse in Pediatric B-ALL Patients with Low End-Induction Minimal Residual Disease

Author

Harris, Marian H., primary, Blonquist, Traci M., additional, Athale, Uma H., additional, Clavell, Luis A., additional, Cole, Peter D., additional, Kelly, Kara M., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Welch, Jennifer J.G., additional, Neuberg, Donna S., additional, Sallan, Stephen E., additional, and Silverman, Lewis B., additional

Published
2015
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43. Effectiveness of Antibacterial Prophylaxis during Induction Chemotherapy in Children with Acute Lymphoblastic Leukemia

Author

Sulis, Maria Luisa, primary, Blonquist, Traci M., additional, Athale, Uma H., additional, Clavell, Luis A., additional, Cole, Peter D., additional, Kelly, Kara M., additional, Laverdiere, Caroline, additional, Leclerc, Jean-Marie, additional, Michon, Bruno, additional, Schorin, Marshall A., additional, Welch, Jennifer J.G., additional, Neuberg, Donna S, additional, Sallan, Stephen E., additional, and Silverman, Lewis B., additional

Published
2015
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45. Red Cell Antigen Genotyping Compared to Standard Serological Phenotyping in Sickle Cell Disease Patients in Canada: Potential for Reducing Alloimmunization

Author

Al-Habsi, Khalid S, primary, Shih, Andrew W., additional, Barty, Rebecca, additional, Wang, Grace, additional, Elahie, Allahna, additional, Azzam, Mona, additional, Siddiqui, Reda, additional, Parvizian, Michael, additional, Heddle, Nancy M, additional, Athale, Uma H., additional, Goldman, Mindy Rona, additional, and Verhovsek, Madeleine M, additional

Published
2015
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46. Dietary Antioxidant Micronutrient Intake and Toxicity during Remission Induction in Children with Acute Lymphoblastic Leukemia (ALL): Results from Dana-Farber Cancer Institute (DFCI) ALL Consortium Trial 05-001

Author

Kelly, Kara M., Ladas, Elena, Blonquist, Traci M., Stevenson, Kristen E., Lin, Meiko, Cole, Peter D, Orjuela, Manuela, Athale, Uma, Clavell, Luis A., Laverdière, Caroline, Leclerc, Jean-Marie, Michon, Bruno, Schorin, Marshall A., Sulis, Maria Luisa, Welch, Jennifer J.G., Asselin, Barbara L, Sallan, Stephen E., and Silverman, Lewis B.

Published
2017
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47. Age and ABO Blood Group Are Significant Predictors of Thrombosis in Children with Acute Lymphoblastic Leukemia (ALL): Results from Dana-Farber Cancer Institute (DFCI) ALL Consortium Trial 05-001

Author

Athale, Uma H., Blonquist, Traci M., Stevenson, Kristen E., Spira, Menachem, Cole, Peter D., Asselin, Barbara L, Clavell, Luis A., Kelly, Kara M., Laverdière, Caroline, Leclerc, Jean-Marie, Michon, Bruno, Schorin, Marshall A., Sulis, Maria Luisa, Welch, Jennifer J.G., Harris, Marian H., Neuberg, Donna S., Sallan, Stephen E., and Silverman, Lewis B.

Published
2017
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49. Erwinia asparaginase after allergy to E. coli asparaginase in children with acute lymphoblastic leukemia

Author

Vrooman, Lynda M., Supko, Jeffrey G., Neuberg, Donna S., Asselin, Barbara L., Athale, Uma H., Clavell, Luis, Kelly, Kara M., Laverdière, Caroline, Michon, Bruno, Schorin, Marshall, Cohen, Harvey J., Sallan, Stephen E., and Silverman, Lewis B.

Subjects
Adolescent, Infant, Antineoplastic Agents, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Survival Analysis, Article, Drug Administration Schedule, Drug Hypersensitivity, Child, Preschool, Escherichia coli, Asparaginase, Erwinia, Humans, Child
Abstract

Escherichia coli asparaginase is an important component of treatment for childhood acute lymphoblastic leukemia (ALL); however, hypersensitivity develops in up to 30% of patients. We assessed the nadir enzyme activity and tolerability of Erwinia asparaginase, an alternative preparation, in E. coli asparaginase-allergic patients.Between 2000 and 2002, 215 children with newly diagnosed ALL were enrolled on Dana-Farber Cancer Institute ALL Consortium Protocol 00-01 and were to receive 30 weekly doses of intramuscular E. coli asparaginase. If E. coli asparaginase allergy developed, patients were switched to twice-weekly intramuscular Erwinia asparaginase (25,000 IU/m(2)). Nadir serum asparaginase activity (NSAA) was measured every 3 weeks.Forty-two patients (20%) developed E. coli asparaginase allergy and switched to Erwinia. Of 38 patients with evaluable samples, 34 (89%) Erwinia-treated patients had at least one therapeutic NSAA (or =0.1 IU/ml). The median NSAA was 0.247 IU/ml 3 days and 0.077 IU/ml 4 days after an Erwinia dose. Associated toxicities included allergy in 14 (33%) and pancreatitis in 3 patients (7%). At a median follow-up of 5.4 years, event-free survival (+/-standard error) of the 42 patients who switched to Erwinia was 86 +/- 5% compared with 81 +/- 3% for the 170 patients without E. coli asparaginase allergy (P = 0.55).Twice-weekly Erwinia asparaginase was well tolerated and achieved a therapeutically effective NSAA in most E. coli asparaginase-allergic patients. Development of E. coli allergy and subsequent treatment with twice-weekly Erwinia did not adversely impact event-free survival. Erwinia asparaginase should be considered for E. coli asparaginase-allergic patients.

Published
2009

50. Intravenous PEG-asparaginase during remission induction in children and adolescents with newly diagnosed acute lymphoblastic leukemia

Author

Silverman, Lewis B., Supko, Jeffrey G., Stevenson, Kristen E., Woodward, Christina, Vrooman, Lynda M., Neuberg, Donna S., Asselin, Barbara L., Athale, Uma H., Clavell, Luis, Cole, Peter D., Kelly, Kara M., Laverdière, Caroline, Michon, Bruno, Schorin, Marshall, Schwartz, Cindy L., O'Brien, Jane E., Cohen, Harvey J., and Sallan, Stephen E.

Published
2010
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