Onkológia 1/2021

Clinical experience with the use of a pegylated form of asparaginase in the treatment of acute lymphoblastic leukemia in adults – a case study

Aim: Acute lymphoblastic leukaemia (ALL) is a haematological malignancy which occurs mainly in childhood, in adults it is the second most common acute leukemia (20% of all leukaemia cases). It is generally associated with the worst survival rates, due to the significant risk of relapse, which is associated with adverse genetic abnormalities in adult patients. In patients treated with intesive pediatric-inspired protocols, a high rate of complete remissions (CR) is achieved as well as the overall survival (OS). The main aim of the case study is to present the case of a young adult patient and our experiences with treatment and post-treatment toxicity management. Case study: We describe the case of a 21-year-old male patient with T-ALL treated with GMALL protocol using a pegylated form of asparaginase. Conslusion: Administration of asparaginase in adults has always been problematic. The toxicity profile of the drug is unique and is used almost exclusively in the treatment of ALL, which may lead to concerns and premature discontinuation of treatment. Despite the toxicity of the drug, majority side effects are not fatal, are well manageable and reversible.

Keywords: acute lymphoblastic leukemia, pegasparaginase, chemotherapy, treatment toxicity