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We monitored AEA in paediatric patients diagnosed with acute lymphoblastic leukaemia (ALL) and treated according to the Chinese Children's Cancer Group study protocols, CCCG\u2010ALL\u20102015\/CCCG\u2010ALL\u20102020 protocols. We measured the AEA at days 7\u2009\u00b1\u20091 and 14\u2009\u00b1\u20091 and analysed their association with patient characteristics and PEG\u2010asparaginase\u2010related adverse effects (AEs). We measured 2147 samples from 329 patients. Mean AEA levels (interquartile range) were 931\u2009iu\/L (654\u20131174\u2009iu\/L) at day 7\u2009\u00b1\u20091 and 664\u2009iu\/L (463\u2013860\u2009iu\/L) at day 14\u2009\u00b1\u20091. The AEA levels were higher in younger children and increased with the cumulative dose numbers. PEG\u2010asparaginase inactivation rate was 19.1%, and the silent inactivation (SI) rate was 12.5%. Nine patients were identified with allergic\u2010like reactions. Hypofibrinogenaemia, hypertriglyceridaemia, pancreatitis and thrombosis were associated with older age, whereas hypoglycaemia was associated with younger age. The risk of hypertriglyceridaemia and hypoglycaemia increased with cumulative dose numbers of PEG\u2010asparaginase. Except for hypofibrinogenaemia, elevated AEA levels did not increase the risk of PEG\u2010asparaginase\u2010related AEs. Drug monitoring can be utilized as guidance for treatment decision\u2010making. Individualizing asparaginase doses do not reduce toxicities. The treatment target of PEG\u2010asparaginase remains to achieve sustained and adequate activity.<\/jats:p>","DOI":"10.1111\/bjh.19605","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T06:41:04Z","timestamp":1719470464000},"page":"624-633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The correlation of asparaginase enzyme activity levels after\n                    <scp>PEG<\/scp>\n                    \u2010asparaginase administration with clinical characteristics and adverse effects in Chinese paediatric patients with acute lymphoblastic leukaemia"],"prefix":"10.1111","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3233-351X","authenticated-orcid":false,"given":"Cai","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology Fujian Medical University, Union Hospital  Fuzhou 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