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What dose of PEG-asparaginase do you recommend for teens with high BMI treated on a pediatric ALL regimen?

Would you plan straight pediatric dosing using 2500 Units/m2 or a cap of 3750 Units as used in some adult ALL regimens due to excess liver/pancreas toxicity?
2 Answers
Mednet Member
Mednet Member
Pediatric Hematology/Oncology · Cleveland Clinic
Answered on

The peg-asparaginase dosing we use in ALL regimens for B and T cell is below:

Patients less than 21 years old – 2500 units/m2

Patients 21 years and older – 2000 units/m2

For obese patients (defined as > 95% BMI for patients less than 20 years old or BMI > 30 for patients 20 years and older), ...

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Mednet Member
Mednet MemberInvited Expert
Medical Oncology · University of Rochester
Answered on

For older adolescents and young adult patients, the optimal dosing of peg-asparaginase is unclear. It is recognized that asparaginase toxicity increases with age, but also with certain comorbid conditions such as diabetes, liver disease, and obesity (BMI >30).

The adolescent and young adult (AYA) AL...

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