Evidence map›Paper›PMID 40916350›Full record

Observational studyBritish journal of haematology2025

Early prediction of subsequent peg-asparaginase inactivation in acute lymphoblastic leukaemia patients-A NOPHO ALL2008 study.

Merete Dam, Maddalena Centanni, Daniel Centanni, Lena E Friberg, Mats O Karlsson, Line S Lynggaard, Inga M Johannsdottir, Kristi Lepik, Goda E Vaitkeviciene, Laimonas Griskevicius and 9 more

Abstract readObservational Study
In one paragraph

Observational study in British journal of haematology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Merete DamDepartment of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.ORCID https://orcid.org/0000-0002-8857-8629
Maddalena CentanniDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.
Daniel CentanniDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.
Lena E FribergDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.
Mats O KarlssonDepartment of Pharmacy, Uppsala University, Uppsala, Sweden.
Line S LynggaardDepartment of Hematology, Aarhus University Hospital, Aarhus, Denmark.
Inga M JohannsdottirDepartment of Paediatric Haematology and Oncology, Oslo University Hospital, Oslo, Norway.
Kristi LepikTallinn Children's Hospital, Tallinn, Estonia.
Goda E VaitkevicieneVilnius University Children's Hospital, Vilniaus, Lithuania.
Laimonas GriskeviciusVilnius University Hospital Santaros Klinikos and Vilnius University, Vilniaus, Lithuania.
Tuuli PöyhönenKuopio University Hospital, Kuopio, Finland.
Marja PyöräläKuopio University Hospital, Kuopio, Finland.
Ólafur G JónssonNational University Hospital of Iceland, Reykjavik, Iceland.
Petter Quist-PaulsenDepartment of Haematology, St. Olavs University Hospital, Trondheim, Norway.
Kjeld SchmiegelowDepartment of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Tania ChristoforakiDepartment of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Ulrik OvergaardDepartment of Haematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Stefan N HansenDepartment of Public Health, Aarhus University, Aarhus, Denmark.
Birgitte K AlbertsenDepartment of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.

Funding

Barncancerfonden PR2021-0064Barncancerfonden PR2023-0050Børnecancerfonden 2018-3682Børnecancerfonden 2020-6755Børnecancerfonden 2022-8167Brogaard FoundationLizzy and Mogens Staal FoundationØlufgaard FoundationThe Health Research Foundation of Central Denmark Region
6 · The paper itself

Abstract

Polyethylene glycol (peg)-asparaginase plays a crucial role in acute lymphoblastic leukaemia (ALL) treatment, yet its associated toxicity often leads to treatment discontinuation, elevating relapse risk. Hypersensitivity with inactivation of asparaginase is common and often associated with severe allergic reactions. This study aims to comprehensively analyse asparaginase enzyme activity (AEA) pharmacokinetics, validate a previously developed pharmacokinetic model based on intravenous administration and evaluate its capability to detect changes in clearance before inactivation in patients treated with intramuscular peg-asparaginase. The study, covering 644 patients aged 1-45 with ALL under the Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL2008 Protocol (February 2017-December 2022, in Nordic and Baltic countries), included 3003 AEA samples. Sampling occurred 14 days post peg-asparaginase doses, with additional sampling between doses. The incidence of inactivation was 15.2%. Utilizing the pharmacokinetic model, estimates revealed an 87.8% sensitivity and 65.5% specificity for detecting increased peg-asparaginase clearance over time in patients experiencing inactivation. Identification of increased clearance preceding inactivation in the NOPHO ALL2008 dataset highlights the potential of pharmacokinetic sampling to predict inactivation and enable timely intervention before clinical manifestation, with further refinement and inclusion of additional protocols into a unified model offering the promise of improving clinicians' ability to assess individual patient risk.

Indexed as

Antineoplastic AgentsAsparaginasePolyethylene GlycolsPrecursor Cell Lymphoblastic Leukemia-LymphomaAdolescentAdultChildChild, PreschoolFemaleHumansInfantMaleMiddle AgedYoung AdultAntineoplastic AgentsAsparaginasepegaspargasePolyethylene GlycolsALLinactivationpeg‐asparaginasepharmacokinetics

Identifiers

PMID40916350
PMCPMC12624184

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.