Do immunoglobulin G and immunoglobulin E anti- l -asparaginase antibodies have distinct implications in children with acute lymphoblastic leukemia? A cross-sectional study

Galindo Rodríguez, Gabriela y Jaime Pérez, José Carlos y Salinas Carmona, Mario César y González Díaz, Sandra Nora y Castro Corona, Ángeles y Cavazos González, Raúl y Treviño Villarreal, Humberto y Heredia Salazar, Alberto Carlos y Gómez Almaguer, David (2017) Do immunoglobulin G and immunoglobulin E anti- l -asparaginase antibodies have distinct implications in children with acute lymphoblastic leukemia? A cross-sectional study. Revista Brasileira de Hematologia e Hemoterapia, 39 (3). pp. 202-209. ISSN 15168484

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URL o página oficial: http://doi.org/10.1016/j.bjhh.2016.11.006

Resumen

Background: l-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. Methods: Under 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. Results: Fifty-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). Conclusion: Children 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.

Tipo de elemento:

Article

Palabras claves no controlados:

Acute Lymphoblastic leukemia, Allergy, hypersensitivity, L-Asparaginase, Neutralizing antibodies, Silent antibodies

Materias:

R Medicina > RC Medicina Interna, Psiquiatría, Neurología

Divisiones:

Medicina

Usuario depositante:

Editor Repositorio

Creadores:

Creador	Email	ORCID
Galindo Rodríguez, Gabriela	NO ESPECIFICADO	NO ESPECIFICADO
Jaime Pérez, José Carlos	NO ESPECIFICADO	NO ESPECIFICADO
Salinas Carmona, Mario César	NO ESPECIFICADO	NO ESPECIFICADO
González Díaz, Sandra Nora	NO ESPECIFICADO	orcid.org/0000-0002-3612-0042
Castro Corona, Ángeles	NO ESPECIFICADO	NO ESPECIFICADO
Cavazos González, Raúl	NO ESPECIFICADO	NO ESPECIFICADO
Treviño Villarreal, Humberto	NO ESPECIFICADO	NO ESPECIFICADO
Heredia Salazar, Alberto Carlos	NO ESPECIFICADO	NO ESPECIFICADO
Gómez Almaguer, David	NO ESPECIFICADO	NO ESPECIFICADO