ArticleBlood advances2023
The impact of early PEG-asparaginase discontinuation in young adults with ALL: a post hoc analysis of the CALGB 10403 study.
Article in Blood advances, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- American Society of Hematology 2026 guidelines for frontline management of acute lymphoblastic leukemia in adolescents and young adults.Blood advances · 2026Guideline
- Optimizing Asparaginase Treatment for Adolescent and Young Adult (AYA) Patients With Acute Lymphoblastic Leukemia: US Consensus Panel Recommendations.American journal of hematology · 2026Guideline
- Asparaginase-Based Treatment Modifications and Their Effect on Pediatric Acute Lymphoblastic Leukemia Outcomes: A Single-Center ExperienceTurkish journal of haematology : official journal of Turkish Society of Haematology · 2026Article
- Toxicity from asparaginase during acute lymphoblastic leukemia induction: a report from the Children's Oncology Group.Blood advances · 2026Article
- Article
- Early prediction of subsequent peg-asparaginase inactivation in acute lymphoblastic leukaemia patients-A NOPHO ALL2008 study.British journal of haematology · 2025Observational
- Venous thromboembolism in adolescents and young adults with acute lymphoblastic leukemia treated on a pediatric-inspired regimen.Blood cancer journal · 2024Article
- Augmented use of L-asparaginase markedly improves AYA ALL outcomes: FBMTG prospective MRD2014 study.Blood neoplasia · 2024Article
- Article
- Asparaginase toxicity in Hispanic adult and pediatric patients with acute lymphoblastic leukemia: current understanding.Expert opinion on drug metabolism & toxicologyReview
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Authors and funding
16 authors at 14 institutions in 1 country.
Funding
Abstract
Asparaginase is a key component of pediatric-inspired regimens in young adults with acute lymphoblastic leukemia (ALL). Truncation of asparaginase therapy is linked to inferior outcomes in children with ALL. However, a similar correlation in adults is lacking. Here, we studied the prevalence and risk factors associated with pegylated (PEG)-asparaginase discontinuation in young adults with ALL treated on the US intergroup Cancer and Leukemia Group B (CALGB) 10403 study and examined the prognostic impact of early discontinuation (ED) (defined as <4 of 5 or 6 planned doses) on survival outcomes. The analysis included 176 patients who achieved complete remission and initiated the delayed intensification (DI) cycle. The median number of PEG-asparaginase doses administered before DI was 5 (range, 1-6), with 57 (32%) patients with ED. The ED patients were older (median, 26 vs 23 years; P = .023). Survival was apparently lower for ED patients compared with those receiving ≥4 doses, but this finding was not statistically significant (hazard ratio [HR], 1.82; 95% confidence interval [CI], 0.97-3.43; P = .06), with corresponding 5-year overall survival (OS) rates of 66% and 80%, respectively. In patients with standard-risk ALL, the ED of PEG-asparaginase adversely influenced OS (HR, 2.3; 95% CI, 1.02-5.22; P = .04) with a trend toward inferior event-free survival (EFS) (HR, 1.84; 95% CI, 0.92-3.67; P = .08). In contrast, there was no impact of early PEG-asparaginase discontinuation on OS (P = .64) or EFS (P = .32) in patients with high-risk disease based on the presence of high-risk cytogenetics, Ph-like genotype, and/or high white blood cell count at presentation. In conclusion, early PEG-asparaginase discontinuation is common in young adults with ALL and may adversely impact survival of patients with standard-risk ALL.
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