{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T15:31:46Z","timestamp":1779377506641,"version":"3.53.1"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T00:00:00Z","timestamp":1666915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A cross\u2010sectional nationwide study was designed to assess national compliance with international consensus\/guidelines of monitoring asparaginase levels in children with acute lymphoblastic leukemia (ALL) treated with asparaginase in routine clinical practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An ad hoc questionnaire was designed and completed by staff physicians from Hemato\u2010Oncology Units throughout Spain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 39 physicians (64% pediatricians) with a mean (SD) age 43.5 (7.9) years and 15.3 (17.6) years of professional activity participated in the study. They accounted for 90% of hospitals in which children with ALL are treated in Spain. A total of 19 participants (48.7%) reported that asparaginase levels were routinely monitored (own center in 2 cases [10.5%], another hospital in 17 cases [89.5%]). Asparaginase was not monitored in 51.3% of the cases, mostly (80%) because unavailability of testing. When asparaginase was monitored, 68% of participants reported that this was done in all asparaginase\u2010treated patients and 84% in all phases of the disease (induction, consolidation, re\u2010induction, maintenance) with a time interval of 7\u2009days for the pegylated form, 48\u2009h for <jats:italic>Erwinia<\/jats:italic> asparaginase and 14\u2009days for maintenance with the pegylated form. All participants reported that they modified treatment according to results of testing, with a limit of total depletion of \u2265100\u2009IU\/L. Levels &lt;100 or 20\u2009IU\/L were considered indicative of hypersensitivity by 46% of physicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is still a gap between what is recommended and what is done in clinical practice, with more than 50% of centers not monitoring the level of asparaginase activity in pediatric ALL. Protocols for asparaginase testing in daily practice should be implemented.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1729","type":"journal-article","created":{"date-parts":[[2022,10,29]],"date-time":"2022-10-29T02:33:36Z","timestamp":1667010816000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Asparaginase activity monitoring in pediatric acute lymphoblastic leukemia: A cross\u2010sectional nationwide study in Spain"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2881-1473","authenticated-orcid":false,"given":"\u00c1lvaro","family":"Lassaletta","sequence":"first","affiliation":[{"name":"Pediatric Hematology\u2010Oncology Department Hospital Infantil Universitario Ni\u00f1o Jes\u00fas  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Research Department, Pharmacy Department Complejo Hospitalario Universitario de Canarias  Santa Cruz de Tenerife Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the PEGASO study investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,28]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"SEER Cancer Statistics Review (CSR)1975\u20102018.Released April 15 2021. 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