Skip Navigation LinksHome > July 2010 - Volume 32 - Issue 5 > A Desensitization Protocol in Children With L-Asparaginase H...
Journal of Pediatric Hematology/Oncology:
doi: 10.1097/MPH.0b013e3181e003c7
Online Articles: Original Articles

A Desensitization Protocol in Children With L-Asparaginase Hypersensitivity

Akbayram, Sinan MD*; Doğan, Murat MD; Akgün, Cihangir MD; Çaksen, Hüseyin MD; Öner, Ahmet Faik MD*

Collapse Box


Background: L-asparaginase is effective in the treatment of malignant diseases, but it has been associated with hypersensitivity reactions in 5% to 45% of the patients.

Purpose: To determine whether a desensitization protocol in children with native Escherichia coli L-asparaginase hypersensitivity allows subsequent safe administration of native E. coli L-asparaginase.

Patients and Methods: A desensitization protocol was used in 9 children with leukemia (n=8) or Langerhans cell histiocytosis (n=1) and previous severe (n=4) or mild/moderate (n=5) L-asparaginase hypersensitivity. Dexamethasone (2 mg/kg intravenously) and pheniramine hydrogen maleate (1 mg/kg intravenously) were administered 1 hour before each of the following L-asparaginase administrations. Subsequently, 0.1%, 1%, 5%, 10%, and the remaining 84% of the total dose of L-asparaginase (10,000 IU/m2) were each prepared in 240 mL 0.9% saline and infused over 4 hours (20 h in total).

Results: After desensitization, none of the patients had recurrence of hypersensitivity reactions during the subsequent 2 to 15 doses (median: 6 doses/patient; 68 doses in total) of native E. coli L-asparaginase.

Conclusion: This desensitization protocol was safe and allows continued administration of native E. coli L-asparaginase administration.

© 2010 Lippincott Williams & Wilkins, Inc.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Connect With Us


For additional oncology content, visit LWW Oncology Journals on Facebook.