Adequate asparaginase is important to prevent central nervous system and testicular relapse of pediatric Philadelphia chromosome‐negative B‐cell acute lymphoblastic leukemia

Asparaginase (Asp) is one of the most important drugs for treating acute lymphoblastic leukemia (ALL). However, off-protocol Asp administration (OPAA) or hypersensitivity may disturb its pharmacokinetic profile. In this retrospective study, we sought to determine whether OPAA and Escherichia coli asparaginase (E Asp) impaired extramedullary relapse prevention in a pediatric ALL cohort treated according SCMC-ALL-2005 protocol from 2005 2014 at Shanghai Children's Medical Center (SCMC). total, 676 patients were enrolled including 369 with 60 exhibiting E Asp. At end recent follow-up, 58 had relapse. The 5-year cumulative incidence was 11.01%, whereas that without 5.28% (P = .0036). Moreover, exhibited 16.48%, 7.59% .0195). Concerning site, not only increased central nervous system (CNS) but testicular as well. Based on Fine Gray multivariate analysis, independent risk factors conclusion, prevent ALL, adequate duration administrate more than total dosage, attention should be paid inadequate due hypersensitivity.