Page 252 - Abstract Book KONIKA 18

Hemato-Oncology

P-HO-048
Adverse Drug Reaction of L-Asparaginase
in Children with Acute Lymphoblastic Leukemia
in Dr. Kariadi General Hospital Semarang: An 18 Months Experience

Galuh Hardaningsih, Moedrik Tamam, Bambang Sudarmanto, Ariawan, Wistiani, Yetty M Nency
Department of Child Health, Faculty of Medicine Universitas Diponegoro/Dr. Kariadi General Hospital,
Semarang, Central Java, Indonesia
Abstract
Background L-Asparaginase is one of a main part in management of children with acute lymphoblastic
leukemia (ALL) despite its significant incidence of adverse drug reaction (ADR). Objective To describe the
prevalence and type of allergic reactions, as well as to identify potential risk factors for the development of
allergic reactions during L-ASP therapy in children with ALL. Methods ALL patients, 1- 18 years of age who
were treated at Kariadi Hospital Semarang during January 2020 - July 2021 were analyzed about the onset,
frequency and type of allergic reactions and type of leukemia risk. Allergic manifestations were observed and
recorded. Results Seventy five children underwent chemotherapy for ALL. There were 8 (10,6%) subjects
with ADR of L Asparaginase whereas 5 subjects with ALL-HR and 3 subjects with ALL-SR. Four subjects
are under 10 y.o. All 8 subjects have skin manifestation of itchy maculopapular rash. In only 1 subject with
ALL-HR we found angioedema, while in one subject with ALL-SR we reported incidence of anaphylaxis
reaction. ADR were experienced by 5 subjects in the first dose administration, 1 subject in second dose
administration, and 2 subjects in the fourth dose administration. All allergic events occur when the drug
was given for a while and is still ongoing this causes L-ASP chemotherapy to be discontinued. There was
incidence of repeated allergies in the next cycle of chemotherapy even though antiallergy has been given.
Conclusion Considering that L-Asp is the main drug for ALL, the incidence of allergy should get serious
attention and consider an appropriate substitute. L-Asp allergic manifestations are found from mild to severe
and always recur on the next administration.
Keywords: ADR; L-Asparaginase

204 KONIKA XVIII Abstract Book