培门冬酰胺酶治疗儿童急性淋巴细胞白血病的不良反应及其防治

Adverse reaction of PEG-ASNase in chemotherapy in childhood acute lymphoblastic leukemia

目的探讨培门冬酰胺酶治疗儿童急性淋巴细胞白血病(ALL)的不良反应及其防治对策。方法回顾性分析23例ALL患儿应用45个疗程的培门冬酰胺酶治疗后的不良反应发生情况,并与既往应用左旋门冬酰胺酶治疗的不良反应情况进行比较。结果 45个疗程中15个疗程发生不良反应,发生率为33.3%(15/45)。不良反应包括过敏反应(6.7%)、凝血异常(15.6%)、高血糖(4.4%)、胃肠道反应(4.4%)。培门冬酰胺酶常见不良反应发生率与既往左旋门冬酰胺酶治疗不良反应发生率的差异无统计学意义。结论培门冬酰胺酶为对左旋门冬酰胺酶过敏的患儿提供了另一个选择,但在化疗过程中同样存在不良反应。

Objectives To explore the adverse reaction and its prevention strategy of polyethylene glycosylated E. coli asparaginase （PEG-ASNase） in treatment of childhood acute lymphoblastic leukemia. Methods The adverse reactions of PEG- ASNase in 23 cases with 45 courses chemotherapy were analyzed retrospectively, and were compared with previous application of L-asparaginase. Results Adverse reactions were found in 15 out of 45 courses with 33.3% （15/45） incidence rate, including anaphylaxis （6.7%）, blood coagulation abnormalities （15.6%）, and hyperglycaemia （4.4%）, gastrointestinal reaction （4.4%）. No significant difference was observed in the incidence of common adverse reactions between PEG-ASNase and L-asparaginase. Conclusions To L-asparaginase allergic children, PEG- ASNase could be another option. However, PEG-ASNase shows simi- lar adverse reactions as L-asparaginase in chemotherapy treatment as well.