{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:12:33Z","timestamp":1784563953133,"version":"3.55.0"},"reference-count":29,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Arch Allergy Immunol"],"abstract":"<jats:p>Introduction: L-asparaginase is a key chemotherapeutic component of acute lymphoblastic leukemia (ALL) regimens. When hypersensitivity reactions (HSRs) occur, limited availability of alternative L-asparaginase preparations can jeopardize adherence to intended chemotherapy protocols. The aim of this study was to assess the impact of L-asparaginase-related hypersensitivity and subsequent desensitization on survival outcomes in patients with ALL. Methods: Children with ALL treated according to the modified St. Jude Total XIII protocol between January 1997 and December 2007 who experienced systemic HSRs to L-asparaginase were included in the study. Recorded variables included demographics, ALL characteristics, event-free survival, desensitization procedure, and premedication regimens. Results: Of 221 children with ALL (65.2% male; median age at diagnosis 6.11 years [3.2\u20139.1]), L-asparaginase HSR rate was 12.6%, including 19 (67.8%) cases of anaphylaxis. Concomitant drug allergies were reported to methotrexate (n = 2), etoposide (n = 2), and daunomycin (n = 1). HSRs were most frequent during remission induction (50%) and least during maintenance (10.7%). Desensitization to asparaginase was performed in 15 patients; others received premedication (n = 5) or E. coli asparaginase was discontinued according to the protocol and replaced with Erwinia or polyethylene glycol (PEG)-asparaginase (n = 8). Among the 190 patients with long-term follow-up, 10-year overall survival was lower in the L-asparaginase-allergic group than in nonallergic patients (20\/26, 76.9% vs. 149\/164, 90.9%; p = 0.035). In the desensitization group (n = 13), the overall survival rates at five and 10 years were 92.3% and 69%, respectively, while in the no desensitization group (n = 13), the rates were 92.3% and 84.6%, respectively (p &gt; 0.05). Conclusion: In this cohort of pediatric patients with ALL, desensitization to L-asparaginase was not associated with a statistically significant difference in prognosis.<\/jats:p>","DOI":"10.1159\/000552669","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T16:02:09Z","timestamp":1779984129000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of L-Asparaginase Hypersensitivity and Desensitization in Children with Acute Lymphoblastic Leukemia"],"prefix":"10.1159","author":[{"given":"Hilal","family":"Unsal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilal Eda","family":"Korkmaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selin","family":"Aytac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umit Murat","family":"Sahiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bulent Enis","family":"Sekerel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Gumruk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7444-251X","authenticated-orcid":false,"given":"Ozge","family":"Soyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25489"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.1981.tb01752.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1080\/10428190701292049"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/pai.13759"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-008-0026-9"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/S1040-8428(98)00015-8"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1515\/dmpt-2016-0033"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1177\/1043454212471728"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403011"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.2217\/fon.14.138"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2401007"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14040902"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2016.1213826"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.10.034"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/mph.0b013e3181e003c7"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1080\/1042819021000055048"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.htct.2019.10.007"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200404000-00002"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2015.137380"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111\/all.15032"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2004.04.029"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-10-534347"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403351"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22225"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1080\/08880018.2019.1634778"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2025.1542649"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2021-1288"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2015.1101098"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-02-628800"}],"container-title":["International Archives of Allergy and Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000552669","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:00:59Z","timestamp":1784563259000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000552669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":29,"URL":"https:\/\/doi.org\/10.1159\/000552669","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32358720","asserted-by":"subject"}]},"ISSN":["1018-2438","1423-0097"],"issn-type":[{"value":"1018-2438","type":"print"},{"value":"1423-0097","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,28]]}}}