ArticleThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG2026
Prevention of Subsequent L-Asparaginase Hypersensitivity in Children Through Premedication: A Single-Center Experience.
Article in The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveL-asparaginase is an essential component of pediatric acute lymphoblastic leukemia (ALL) treatment. However, hypersensitivity reactions can occur, necessitating a switch to alternative asparaginase formulations. In resource-limited settings, access to pegylated asparaginase and
methodsA retrospective cohort study was conducted in 119 children with ALL treated with L-asparaginase at Chiang Mai University Hospital. Ten patients (8.4%) developed severe systemic hypersensitivity reactions. Subsequent intramuscular L-asparaginase doses were preceded by a standardized premedication protocol comprising oral prednisolone, cetirizine, and montelukast, along with preinfusion intravenous hydrocortisone.
resultsA total of 76 subsequent L-asparaginase doses were administered following premedication. Seven episodes (9.2%) of recurrent hypersensitivity reactions occurring within 5 to 40 minutes of L-asparaginase dosing occurred in 6 patients. Most reactions were mild and managed with additional antihistamines and corticosteroids. One episode required treatment with intramuscular epinephrine. All patients successfully completed their prescribed course of L-asparaginase therapy.
conclusionIn resource-limited settings, our premedication protocol demonstrated potential for safely enabling continued native
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