{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:01:51Z","timestamp":1788915711106,"version":"build-2803163510"},"reference-count":70,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011096","name":"Jazz Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011096","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Asparaginase is an integral component of therapy for pediatric patients with acute lymphoblastic leukemia\/lymphoblastic lymphoma. The success of asparaginase\u2010containing regimens has led to trials of pediatric\/pediatric\u2010inspired regimens incorporating asparaginase for treating adolescent and young adult (AYA) and adult populations with acute lymphoblastic leukemia\/lymphoblastic lymphoma. While treatment of AYA patients with these regimens is associated with improved clinical outcomes compared with adult\u2010specific protocols, AYA patients face unique challenges with these treatments, further complicated by a rapidly evolving therapeutic landscape. In this article, we identify barriers and other feasibility issues associated with administering asparaginase\u2010based treatment to AYA patients and provide recommendations from a consensus panel of experts to optimize AYA patient outcomes and experiences. Barriers identified include the limited access to clinical trials and specialized expertise in pediatric\u2010inspired regimens for AYA patients compared with pediatric patients, the complex management of asparaginase toxicities, limited medical facilities and experienced staff to administer and manage pediatric\u2010inspired regimens, and reduced AYA patient access\/adherence to treatment due to lifestyle\u2010related or psychosocial challenges. Recommendations are provided on addressing and managing these challenges to improve asparaginase\u2010based treatment accessibility and safety in AYA patients, including specific recommendations for high\u2010risk populations.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    : NCT04817761\n                  <\/jats:p>","DOI":"10.1002\/ajh.70103","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:24:59Z","timestamp":1760178299000},"page":"41-55","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Optimizing Asparaginase Treatment for Adolescent and Young Adult (\n                    <scp>AYA<\/scp>\n                    ) Patients With Acute Lymphoblastic Leukemia:\n                    <scp>US<\/scp>\n                    Consensus Panel Recommendations"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9564-4498","authenticated-orcid":false,"given":"Ibrahim","family":"Aldoss","sequence":"first","affiliation":[{"name":"Division of Leukemia, Department of Hematology and Hematopoietic Cell Transplantation City of Hope National Medical Center  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Ali","sequence":"additional","affiliation":[{"name":"University of Southern California Norris Cancer Hospital  Los Angeles California USA"},{"name":"University of Southern California Mann School of Pharmacy  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan D.","family":"Cassaday","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology University of Washington School of Medicine  Seattle Washington USA"},{"name":"Clinical Research Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily K.","family":"Curran","sequence":"additional","affiliation":[{"name":"University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5781-4529","authenticated-orcid":false,"given":"Marlise R.","family":"Luskin","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke D.","family":"Maese","sequence":"additional","affiliation":[{"name":"Primary Children's Hospital University of Utah\u2010Huntsman Cancer Center  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1487-6818","authenticated-orcid":false,"given":"Etan","family":"Orgel","sequence":"additional","affiliation":[{"name":"Cancer and Blood Disease Institute Children's Hospital of Los Angeles  Los Angeles California USA"},{"name":"Keck School of Medicine University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Douer","sequence":"additional","affiliation":[{"name":"University of Southern California Medical Center  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Childhood Cancer and Functional Impacts Across the Care Continuum","author":"National Academies of Sciences, Engineering, and Medicine; 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R.","year":"2022","journal-title":"Blood and Lymphatic Cancer"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-10-881961"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26066"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2017.265"},{"key":"e_1_2_11_22_1","unstructured":"Referenced With Permission From the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Acute Lymphoblastic Leukemia V.3.2024 National Comprehensive Cancer Network Inc. 202X. All Rights Reserved Accessed April 18 2025 To View the Most Recent and Complete Version of the Guideline go Online to NCCN.org. NCCN Makes no Warranties of Any Kind Whatsoever Regarding Their Content Use or Application and Disclaims Any Responsibility for Their Application or Use in Any Way."},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023023568"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26555"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1200\/OP.21.00178"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.902117"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-020-00597-y"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-11-551481"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23149"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2023-189553"},{"issue":"12","key":"e_1_2_11_31_1","first-page":"1080","article-title":"Treatment of Acute Lymphoblastic Leukemia in Adults: Applying Lessons Learned in Children","volume":"30","author":"Aldoss I. 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