Does age impact adverse events in adolescents and young adults treated
with PEG-asparaginase treatment at a Canadian pediatric tertiary
hospital? A retrospective review examining the role of age in the
presentation of PEG-asparaginase side effects
Abstract
Background: Adolescents and young adults (AYA) with cancer have less
favorable outcomes than other populations for lymphoid malignancies.
Pediatric patients have a better survival rate for lymphoid malignancies
and current evidence suggests that asparaginase plays a role in improved
response to treatment. This study aimed to evaluate if AYA patients at a
pediatric hospital were more likely to experience PEG-asparaginase
(PEG-ASP) related adverse events than younger patients. Methods: A
retrospective chart review from 2007-2017 was conducted in the pediatric
population at the Children’s Hospital of Eastern Ontario (CHEO). Only
patients having received PEG-ASP were included. Event incidence and risk
related to age at diagnosis was assessed through parameter estimates and
Wald Chi Square analysis. Results: In total, 75 adverse events were
observed: 34/186 (18.3%) experienced allergic reactions, 8/186 (4.3%)
pancreatitis, 31/186 (16.7%) thrombosis and 2/186 (1.1%) hemorrhage.
182 patients had complete information for inclusion in in our model. A
correlation between age at diagnosis and higher risk of allergic
reaction (p<0.001) and pancreatitis (p<0.035) was
observed. Conclusion: Allergic reaction and pancreatitis upon
administration of PEG-ASP have a higher risk of occurrence as age of
diagnosis increases. This includes the AYA population and warrants
precaution as PEG-ASP is included in older populations treatment
regimens at pediatric centers.