| Objective Optimizing the application of polyethylene glycolconjugated asparaginase（PEG-ASP）in treatment of childhood acutelymphoblastic leukemi（aALL），we want to reduce the secondary reaction and improve the chemotherapy effect. Methods26patients withdiagnosed ALL were received PEG-ASP treatment form February,2013,monitoring the activities of asparaginase（ASP）and the concentrations ofasparagine(ASN), some related blood biochemical criterions weredetected as well. Some patinets will adjust the dosage and frequency ofPEG-ASP according to monitoring indexes,even change another kinds ofASP. Results26children were enrolled.6（23%）children’s activitiesof ASP and the concentrations of ASN were abnormal，4(67%) of themwith anaphylactic ASP reaction. ASP activities of two patients(7%) werelow，and they were treated with L-asp form Erwinia and the activitiescame to normal.1(4%) child only used PEG-ASP one time according tothe activity of ASP and the concentration of ASN.9(34%) children hadhigh levels of alanine transaminase(ALT) and total bilirubin, respectively.11（42%）children had a hypoproteinemia.2(7%)children had a prolongedprothrombin time(PT) and10(38%) cases had prolonged activated partialthromboplastin time(APTT). Conclusion The PEG-ASP can reduce theconcentration of asparagine effectively. Anaphylactic reaction has astrong impact on the chemotherapy effect. It’s effective to Erwinia L-aspafter PEG-ASP resistant. Part of the cases can get a long acting aftersingle treatment of PEG-ASP. |
