TY - JOUR T1 - Do immunoglobulin G and immunoglobulin E anti-l-asparaginase antibodies have distinct implications in children with acute lymphoblastic leukemia? A cross-sectional study JO - Hematology, Transfusion and Cell Therapy T2 - AU - Galindo-Rodríguez,Gabriela AU - Jaime-Pérez,José C. AU - Salinas-Carmona,Mario C. AU - González-Díaz,Sandra N. AU - Castro-Corona,Ángeles AU - Cavazos-González,Raúl AU - Treviño-Villarreal,Humberto AU - Heredia-Salazar,Alberto C. AU - Gómez-Almaguer,David SN - 15168484 M3 - 10.1016/j.bjhh.2016.11.006 DO - 10.1016/j.bjhh.2016.11.006 UR - http://www.htct.com.br/pt-do-immunoglobulin-g-immunoglobulin-e-articulo-S1516848417300026 AB - Backgroundl-Asparaginase is essential in the treatment of childhood acute lymphoblastic leukemia. If immunoglobulin G anti-l-asparaginase antibodies develop, they can lead to faster plasma clearance and reduced efficiency as well as to hypersensitivity reactions, in which immunoglobulin E can also participate. This study investigated the presence of immunoglobulin G and immunoglobulin E anti-l-asparaginase antibodies and their clinical associations. MethodsUnder 16-year-old patients at diagnosis of B-cell acute lymphoblastic leukemia confirmed by flow cytometry and treated with a uniform l-asparaginase and chemotherapy protocol were studied. Immunoglobulin G anti-l-asparaginase antibodies were measured using an enzyme-linked immunosorbent assay. Intradermal and prick skin testing was performed to establish the presence of specific immunoglobulin E anti-l-asparaginase antibodies in vivo. Statistical analysis was used to investigate associations of these antibodies with relevant clinical events and outcomes. ResultsFifty-one children were studied with 42 (82.35%) having anti-l-asparaginase antibodies. In this group immunoglobulin G antibodies alone were documented in 10 (23.8%) compared to immunoglobulin E alone in 18 (42.8%) patients. Immunoglobulin G together with immunoglobulin E were simultaneously present in 14 patients. Children who produced exclusively immunoglobulin G or no antibodies had a lower event-free survival (p-value=0.024). Eighteen children (35.3%) relapsed with five of nine of this group who had negative skin tests suffering additional relapses (range: 2–4), compared to none of the nine children who relapsed who had positive skin tests (p-value<0.001). ConclusionChildren with acute lymphoblastic leukemia and isolated immunoglobulin G anti-l-asparaginase antibodies had a higher relapse rate, whereas no additional relapses developed in children with immunoglobulin E anti-l-asparaginase antibodies after the first relapse. ER -