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The important role of tiandonamidease in the treatment of acute lymphoblastic leukemia (ALL) has been clarified.
Based on most current treatments, the overall survival rate of ALL children has exceeded 90%, but the toxicity associated with winteramidease remains an important issue that, in addition to causing acute death, may also increase the risk of recurrence after drug suspension.
the study looked at the risk of recurrence after exposure to ternominease in 1,401 children aged 1-17, who were diagnosed with ALL between July 2008 and February 2016 and treated under the NOPHO ALL2008 program, including prolonged exposure to doteroamidease (5-33 weeks of muscle injection 1000U/m2).
follow-up until the end of recurrence, death, secondary malignancies, or follow-up (median time 5.71 years, four-digit range: 4.02-7.64).
In the multi-factor Cox model, the adjusted recurrence-specific risk ratio (aHR) was 1.33 (95% CI:0.86-2.06, P-0.20) compared to patients who had been deactivated due to clinical toxicity and who were not treated with teterodonamidease (n=1043).
in a sub-study of patients with enzyme activity information only (n-1115), 301 patients who stopped the treatment of dosingamidease or who were silent inactivated (SI) (157 hypersensitive reactions, 53 pancreatitis, 14 thrombosis) The 7-year cumulative recurrence rate of 31 other, 46 SI patients was 11.1% (95% CI: 6.9-15.4), while the remaining 814 patients had 6.7% (4.7-8.6).
recurrence-specific aHR is 1.69 (95% CI: 1.05 to 2.74, P=0.03).
1.83 (95% CI: 1.0 7 to 3.14, P=0.03) and 1.86 (95% CI: 0.90 to 3.87, P=0.095) respectively.
, the results emphasize the importance of therapeutic drug monitoring and, where feasible, the appropriate adjustment of the therapy of winteramidease.