The frequency and management of asparaginase-related @entity715 in paediatric and adult @entity1 with @entity981 treated on Dana-Farber XXXX Institute consortium protocols.

@entity1 @entity981 @entity548 @entity5 @entity1415 @entity2981 @entity715 @entity1211 @entity50
The optimal management of asparaginase-associated @entity715 complications is not well-defined. We report the features, management and outcome of paediatric (ages 0-18years) and adult (18-50years) @entity1 with @entity981 ( @entity981 ) with asparaginase-related @entity1211 ( @entity1211 ) treated at Dana-Farber @entity5 Institute on clinical trials for newly diagnosed @entity981 between 1991-2008. Of 548 @entity1 , 43 (8%) had @entity1211 , including 27/501 (5%) paediatric and 16/47 (34%) adult @entity1 . @entity50 occurred in 1  6% of @entity1 . Age was the only significant predictor of @entity1211 , with those aged >30years at very high risk ( @entity1211 rate 42%). 74% of @entity1 received low molecular weight heparin after @entity1211 . Complications of anticoagulation included @entity1415 (9%), @entity2981 (2%) and, in two adult @entity1 , major @entity548 . Thirty @entity1 (70%) ultimately received at least 85% of the intended doses of asparaginase. 33% of @entity1 experienced recurrent @entity1211 (paediatric 17% vs. adults 47%, P=0  07). The 48-month event-free survival for @entity1 with @entity1211 was 85  6% compared with 88  2% for those without @entity1211 (P=0  36). This study confirms that, after @entity1211 , asparaginase can be restarted with closely monitored anticoagulation after imaging demonstrates clot stabilization or improvement. With this management strategy, a history of @entity1211 does not appear to adversely impact prognosis.
