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Pegaspargase: Two Pediatric Case Studies of Delayed Urticaria Preceding Anaphylactic Reactions Postadministration

Kathleen R Busack1

  • 1Nationwide Children's Hospital.

Clinical Journal of Oncology Nursing
|September 17, 2021
PubMed

Insights

Pegaspargase can cause delayed hypersensitivity reactions in acute lymphoblastic leukemia patients. Advanced practice nurses must monitor for unusual reactions, including severe anaphylaxis, after chemotherapy administration.

Area of Science:

  • Oncology
  • Pharmacology
  • Immunology

Background:

  • Pegaspargase is a chemotherapy agent used in treating acute lymphoblastic leukemia (ALL).
  • Hypersensitivity reactions are a known risk associated with pegaspargase therapy.
  • Early identification and management of adverse drug reactions are crucial in pediatric oncology.

Purpose of the Study:

  • To report unusual delayed hypersensitivity reactions to pegaspargase in pediatric patients with ALL.
  • To emphasize the need for vigilance among healthcare providers regarding potential severe allergic responses to chemotherapy.
  • To highlight the role of advanced practice nurses in recognizing and managing uncommon adverse events.

Main Methods:

  • Case report of two pediatric patients treated with pegaspargase for ALL.
  • Detailed clinical observation of patient responses following sequential doses of the drug.
  • Review of hypersensitivity reaction patterns and timing.

Main Results:

  • Two patients experienced disseminated urticaria approximately two weeks after their second dose of pegaspargase.
  • Both patients subsequently developed severe anaphylaxis upon receiving their third dose of pegaspargase.
  • These reactions were unusual in their delayed onset and severity.

Conclusions:

  • Delayed hypersensitivity reactions, including anaphylaxis, can occur with pegaspargase administration.
  • Advanced practice nurses should maintain a high index of suspicion for atypical chemotherapy side effects.
  • Prompt recognition and intervention are vital for patient safety during pegaspargase treatment.

Keywords:
acute lymphoblastic leukemiahypersensitivitypediatricpegaspargaseurticaria

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