The rate and risk factors for pegasparaginase toxicities in adults
| Toxicity . | Any grade (%) . | High grade (≥ 3) (%) . | Risk factors . |
|---|---|---|---|
| Hypersensitivity | 7-22 | 4-10 | Second dose and future doses, HLA-DRB1*07:01 polymorphism, no concurrent rituximab administration, younger age, no pre-medications |
| Hyperbilirubinemia | 86 | 24-39 | During the induction cycle, older age, obesity, higher dose of pegasparaginase, low albumin, low platelet count, CC genotype of rs4880 polymorphism |
| Pancreatitis | 24 | 5-13 | Older age, high-risk ALL stratification, germline polymorphisms in ULK2 variant rs281366 and RGS6 variant rs17179470 |
| Hypertriglyceridemia | 77 | 11-51 | Beyond first cycle, high BMI, younger age |
| Thrombosis | 11-27 | First cycle, older age, obesity, mediastinal mass, cryoprecipitate replacement | |
| Hypofibrinogenemia (<100) | 48-51 | First cycle, severe obesity (BMI >35) | |
| Hyperglycemia | 91 | 31-33 | Concomitant use of steroid |
| Toxicity . | Any grade (%) . | High grade (≥ 3) (%) . | Risk factors . |
|---|---|---|---|
| Hypersensitivity | 7-22 | 4-10 | Second dose and future doses, HLA-DRB1*07:01 polymorphism, no concurrent rituximab administration, younger age, no pre-medications |
| Hyperbilirubinemia | 86 | 24-39 | During the induction cycle, older age, obesity, higher dose of pegasparaginase, low albumin, low platelet count, CC genotype of rs4880 polymorphism |
| Pancreatitis | 24 | 5-13 | Older age, high-risk ALL stratification, germline polymorphisms in ULK2 variant rs281366 and RGS6 variant rs17179470 |
| Hypertriglyceridemia | 77 | 11-51 | Beyond first cycle, high BMI, younger age |
| Thrombosis | 11-27 | First cycle, older age, obesity, mediastinal mass, cryoprecipitate replacement | |
| Hypofibrinogenemia (<100) | 48-51 | First cycle, severe obesity (BMI >35) | |
| Hyperglycemia | 91 | 31-33 | Concomitant use of steroid |
BMI, body mass index.