Summary

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• This summary is based on the review of two systematic review(s)/meta-analysis(es). ^[1-2]
• No significant difference in Event-Free Survival (EFS) or Overall Survival (OS) was observed between intermittent PEG-asparaginase (eight doses) and continuous PEG-asparaginase (15 doses) in non-high risk acute lymphoblastic leukemia (ALL) patients, as well as between low-risk standard treatment with additional PEG-asparaginase (six doses) and standard treatment (two doses), with risk ratios (RR) close to 1.
• Calaspargase (11 doses) showed a significant reduction in leukemic relapse compared to PEG-asparaginase (16 doses) with an RR of 0.32 (95% confidence interval (CI): 0.12 to 0.83), but no significant difference in EFS (RR 1.06).
• PEG-asparaginase administered intermittently (eight doses) compared to continuous treatment (15 doses) was associated with reduced pancreatitis (RR 0.31) and asparaginase-associated toxicity (RR 0.53), but possible reduction in hypersensitivity (RR 0.64) and thromboembolism (RR 0.55) showed less conclusive results.
• In comparison, adding PEG-asparaginase to low-risk standard treatment increased hypersensitivity (RR 12.05) and pancreatitis (RR 4.84) without a significant difference in thromboembolism or osteonecrosis.
• PEG-asparaginase was primarily studied in children and adolescents aged 1.0 to 17.9 years with non-high risk acute lymphoblastic leukemia (ALL) and in participants aged 1 to 9 years with low-risk ALL. Additionally, Calaspargase was studied in adolescents and young adults (AYA) up to 21 years old with standard- and high-risk ALL and lymphoblastic lymphoma, showing reduced leukemic relapse compared to PEG-asparaginase in this group.