{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T15:31:43Z","timestamp":1779377503506,"version":"3.53.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T00:00:00Z","timestamp":1581638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003441","name":"Universitair Ziekenhuis Gent","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003441","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Asparaginase (ASNase) is an important anti\u2010leukaemic drug in the treatment of childhood acute lymphoblastic leukaemia (ALL) and non\u2010Hodgkin lymphoma (NHL). A substantial proportion of patients develop hypersensitivity reactions with anti\u2010ASNase neutralising antibodies, resulting in allergic reactions or silent inactivation (SI), and characterised by inactivation and rapid clearance of ASNase. We report results of a prospective, real\u2010time therapeutic drug monitoring of pegylated <jats:italic>Escherichia coli<\/jats:italic> (PEG\u2010)ASNase and <jats:italic>Erwinia<\/jats:italic> ASNase in children treated for ALL and NHL in Belgium. <jats:italic>Erwinia<\/jats:italic> ASNase was given as second\u2010line after hypersensitivity to PEG\u2010ASNase. In total, 286 children were enrolled in the PEG\u2010ASNase cohort. Allergy was seen in 11\u00b72% and SI in 5\u00b72% of patients. Of the 42 patients treated with <jats:italic>Erwinia<\/jats:italic> ASNase, 7\u00b71% experienced allergy and 2\u00b74% SI. The median trough PEG\u2010ASNase activity was high in all patients without hypersensitivity. After <jats:italic>Erwinia<\/jats:italic> administration significantly more day 3 samples had activities &lt;100\u00a0IU\/l (62\u00b75% vs. 10% at day 2 (D2)). The median D2 activity was significantly higher for intramuscular (IM; 347\u00a0IU\/l) than for intravenous <jats:italic>Erwinia<\/jats:italic> administrations (159\u00a0IU\/l). This prospective, multicentre study shows that monitoring of ASNase activity during treatment of children with ALL and NHL is feasible and informative. Treatment with <jats:italic>Erwinia<\/jats:italic> ASNase warrants close monitoring and optimally adherence to a 2\u2010day interval of IM administrations.<\/jats:p>","DOI":"10.1111\/bjh.16495","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T11:20:32Z","timestamp":1581679232000},"page":"105-114","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Prospective, real\u2010time monitoring of pegylated <i>Escherichia coli<\/i> and <i>Erwinia<\/i> asparaginase therapy in childhood acute lymphoblastic leukaemia and non\u2010Hodgkin lymphoma in Belgium"],"prefix":"10.1111","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0401-2100","authenticated-orcid":false,"given":"Veerle","family":"Mondelaers","sequence":"first","affiliation":[{"name":"Pediatric Hematology\u2010Oncology and Stem Cell Transplantation Ghent University Hospital and Cancer Research Institute Ghent Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Ferster","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\u2010Oncology H\u00f4pital Universitaire des Enfants Reine Fabiola (HUDERF\u2010UKZKF) Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Uyttebroeck","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\u2010Oncology University Hospital Gasthuisberg Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9n\u00e9dicte","family":"Brichard","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\u2010Oncology Cliniques Universitaires Saint\u2010Luc (UCL) Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jutte","family":"van der Werff ten Bosch","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\u2010Oncology UZ Brussel Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koenraad","family":"Norga","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\u2010Oncology University Hospital Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Francotte","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology CHC\u2010 Hospital of Hope Montegn\u00e9e Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Piette","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology CHR Citadelle Li\u00e8ge Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrien","family":"Vandemeulebroecke","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\u2010Oncology and Stem Cell Transplantation Ghent University Hospital Ghent 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