Treatment of Children with Advanced-Stage Lymphoblastic Lymphoma with Pegaspargase

Objective: to evaluate the feasibility of pegaspargase instead of l-asparaginase to treat children with advanced-stage lymphoblastic lymphoma (lbl) on the berlin-frankfurt-munster (bfm)-95 protocol. methods: fifty-four newly diagnosed patients with stage iii or iv lbl and without any treatment were enrolled in this study. pegaspargase took place of l-asparaginase in bfm-95. the complications and treatment responses of patients treated on the bfm-95 protocol and modified bfm-95 protocol were then evaluated respectively. findings: for lbl patients treated with bfm-95 protocol or modified bfm-95 protocol, the complete response, event-free survival, overall survival were similar. stage 4 myelosuppression was the most common complication in both groups. besides that, among 31 patients receiving modified bfm-95 protocol, coagulation defects were the most common complication. in contrast, anaphylactic reaction was the most common complication in the other 23 patients receiving bfm-95 protocol. conclusion: modified bfm-95 protocol is available to children with advanced-stage lbl with an equal outcome and enhances its compliance and decreases the incidence of anaphylactic reaction, compared to bfm-95 protocol. coagulation defects are the major complication and tolerable in modified one.