Comparison of L-Asparaginase Skin Test According to Test Interval in the Treatment of Pediatric Acute Lymphoblastic Leukemia

김경덕; 박애령; 김순주; 황보신이; 나현오

Comparison of L-Asparaginase Skin Test According to Test Interval in the Treatment of Pediatric Acute Lymphoblastic Leukemia

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소아 급성림프구성백혈병 치료에서 L-asparaginase의skin test 시행 방법의 적절성 평가

Type: Academic journal

Author: 김경덕 박애령 김순주 황보신이 나현오

Journal: 한국병원약사회 병원약사회지 병원약사회지 제35권 제1호 KCI Accredited Journals

Published: 2018.1

Pages: 59 - 66 (8page)

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Comparison of L-Asparaginase Skin Test According to Test Interval in the Treatment of Pediatric Acute Lymphoblastic Leukemia

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Background and Objective : L-asparaginase is the chemotherapeutic agent for the treatment of acute lymphoblastic leukemia and is associated with hypersensitivity reactions. Because of the high rates of hypersensitivity reactions, skin test has been proposed. However, the method of skin test not standardized, and false-positive and false-negative results have been documented. We have conducted skin tests prior to every dose of L-asparaginase. In consideration of the convenience of administration, the skin test is changed to be conducted prior to the first dose of L-asparaginase and prior to restarting therapy after an interval of a week or more has elapsed between doses by intervention of a pediatric oncology pharmacist. The objective of this study was to evaluate the sensitivity and specificity of skin tests. Methods : From July-December 2012, patients that received skin tests prior to every dose of Lasparaginase were classified A group. From July-December 2013, patients that received skin tests prior to the first dose of L-asparaginase and prior to restarting therapy after an interval of a week or more has elapsed between doses were classified B group. Results : 63 patients were included in the A group and received 402 cases of skin tests. 65 patients were included in the B group and received 126 cases of skin tests. The sensitivity of skin tests in the B group (52.2%) was superior to the A group (20%). This result showed statistically significant difference (p=0.047). The specificity of skin tests in the A group (96.1%) was superior to the B group (90.3%). This result showed statistically significant difference (p=0.017). Conclusion : In conclusion, reducing the number of skin tests by intervention of a pediatric oncology pharmacist improved convenience of administration and enhanced clinical safety of chemotherapy.

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References (19)

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Capizzi RL / 1971 / L-Asparaginase: Clinical, Biochemical, Pharmacological, and Immunological Studies / Ann Intern Med 74(6):893~902

Billett AL / 1992 / Allergic reactions to Erwinia asparaginase in children with acute lymphoblastic leukemia who had previous allergic reactions to escherichia coli asparaginase / Cancer 70(1):201~206

Woo MH / 1998 / Anti-asparaginase antibodies following E. coli asparaginase therapy in pediatric acute lymphoblastic leukemia / Leukemia 12(10):1527~1533

Khan A / 1971 / Atopic hypersensitivity to L-Asparaginase / Int Arch Allergy 40(3):463~469

Fabry U / 1985 / Anaphylaxis to L-asparaginase during treatment for acute lymphoblastic leukemia in children--evidence of a complement-mediated mechanism / Pediatr Res 19(4):400~408

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