Switch of Asparaginase Formulation Based on Antibody Monitoring in Adults with Philadelphia-Negative Adult Lymphoblastic Leukemia. Results of the Graall-2014 Trial

• Published in: Blood 2024-11, Vol.144, p.1434-1434
• Main Authors: Balsat, Marie, Orvain, Corentin, Benoist, Jean-François, De Roux, Nicolas, Leguay, Thibaut, Huguet, Françoise, Chevallier, Patrice, Josson, Cendrine, Bain-Wendlinger, Christine, Hicheri, Yosr, Thiebaut, Anne, Escoffre-Barbe, Martine, Cluzeau, Thomas, Pasquier, Florence, Berceanu, Ana, Van Obbergh, Florence, Frayfer, Jamilé, Guillerm, Gaëlle, Cacheux, Victoria, Plantier, Isabelle, Sanhes, Laurence, Himberlin, Chantal, Vargaftig, Jacques, Tricot, Sabine, Chalandon, Yves, Graux, Carlos, Lheritier, Véronique, Dombret, Hervé, Mathilde, Hunault-Berger, Boissel, Nicolas
• Format: Article
• Language: English
• ISSN: 0006-4971
• DOI: 10.1182/blood-2024-199110

Introduction: For over two decades, asparaginase-based regimen have contributed to the improved outcome of young adults with Ph-negative (Ph-) acute lymphoblastic leukemia (ALL). The use of E. coli-derived asparaginase (ASPA) can be responsible for numerous adverse effects, including silent hypersensitivity, in up to 50% of patients (pts), which has been associated with enzyme inactivation. In the GRAALL-2014 trial, patients (pts) received ASPA in induction and late intensification (LI) phases, with activity monitoring and assessments for anti-ASPA antibodies. Those exhibiting low activity, any clinical allergy to ASPA, or the presence of anti-ASPA antibodies were considered for switching to Erwinase (ERW) during LI. Here we report on the results of this strategy. Patients and methods: Between 2014 and 2020, the multicenter French-Belgian-Swiss GRAALL-2014 trial enrolled 743 adult pts with newly diagnosed Ph- ALL, including 489 with BCP-ALL and 254 with T-ALL. During induction and LI, ASPA was administered as follows: for pts