Discipline: Social, Behavioral, and Economic Sciences
Subcategory: Cancer Research
Christina Ann Moore - University of Arkansas at Pine Bluff
Co-Author(s): Belinda Mandrell, Emily Browne, April Sykes, and Zhaohua Lu, St. Jude Children's Research Hospital, Memphis TN
Background: Asparaginase poses a substantial risk for hypersensitive reactions during and after administration; however, these reactions vary by the type of asparaginase and route of administration. PEG-asparaginase administered intravenously (IV) has been found to have fewer incidences of hypersensitivity when compared to intramuscular. It is imperative that nurses be knowledgeable of potential side effects associated with PEG-asparaginase IV administration, as well as the typical timing of these reactions without ignoring the possibility of a delayed reaction. Purpose: The purpose of this retrospective study was to describe the clinical factors associated with hypersensitive reactions to PEG-asparaginase and to support the development of evidence-based monitoring guidelines. Methods: Clinical data including the frequency of reactions, the dose of asparaginase, the severity of the reaction, the timing of the event during treatment, and the time frame between administration and reaction were collected on patients who were identified as having a hypersensitive reaction to PEG-asparaginase while undergoing treatment for Acute Lymphoblastic Leukemia.Results: 63 patients (12.8%) suffered an allergic reaction to PEG-asparaginase. Patients experienced this reaction at a median of 3 doses in both low and standard/high risk patients. An adverse reaction was noted 60 minutes after the initiation of administration in 98% of patients, and no reactions were fatal. Conclusion: Nurses are in an optimal position to actively monitor and anticipate an adverse reaction to PEG-asparaginase. Patients should be carefully observed over the 60-minute course of PEG-asparaginase IV administration, and patients and parents should be aware of the rare occurrence of delayed reactions.
Funder Acknowledgement(s): National Institute of Health; St. Jude Children's Research Hospital.
Faculty Advisor: Anissa Buckner, firstname.lastname@example.org
Role: As a student researcher in the Division of Nursing Research at St. Jude Children' Research Hospital this summer I conducted a retrospective study which involved the extensive review of patient medical records in order to describe the clinical characteristics of patient hypersensitive reactions including Medication administration record summaries, clinical documents, nurse progress notes, and protocol roadmaps.