How can you increase asparaginase adherence and manage hypersensitivity in adults with ALL?

During the 64th American Society of Hematology (ASH) Annual Meeting and Exposition, the ALL Hub spoke with Kjeld Schmiegelow, University of Copenhagen, Copenhagen, DK. We asked, How can you increase asparaginase adherence and manage hypersensitivity in younger and older adults with ALL?

Schmiegelow begins by discussing the main challenges associated with asparaginase treatment, such as recognizing when it should be incorporated into therapy and the management severe toxicities; he highlights several studies examining the response to treatment in terms of effectiveness and the likelihood of relapse. He then goes on to mention the burden of toxicities including hypersensitivity, thromboembolism, hyperlipidemia, and pancreatitis. He concludes with hypersensitivity management strategies, explaining that re-exposure can be useful in patients with an anticipated high risk of relapse whereas truncation of asparaginase can be helpful in low-risk (MRD negative postinduction) patients.