ALLERGIC REACTION TO ESCHERICHIA COLI-ASPARAGINASE IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA: A STUDY IN A TERTIARY HOSPITAL IN INDONESIA

Objective: The objective of the study was to determine and describe the characteristics of allergic reactions to Escherichia coli-Asparaginase (E. coli-ASP). Methods: This cross-sectional study was performed at Hasan Sadikin Bandung General Hospital on acute lymphoblastic leukemia patients diagnosed from January 1, 2018, to August 31, 2019, confirmed by bone marrow examination. Data were extracted from Bandung Online Pediatric Cancer Registry, medical records, protocol therapy documents, and interview with patient’s guardian. Results: Out of 68 patients, 26 patients (37.6%) were allergic to E. coli-ASP. Twenty-two patients with recorded manifestation’s data evoked 35 symptoms and graded according to common terminology criteria for adverse event v3.0., fever, and urticaria are the most frequent manifestation. While Grade 2 and Grade 3 are the most often developed allergic reaction, patients with age range from 1 to 14 years, male and high risk is mainly allergic. Conclusion: Allergic rate to E. coli-ASP at Hasan Sadikin General Hospital is 37.6%. The most frequent manifestation is fever and urticaria (20%, respectively), Grades 2 and 3 (32%, respectively), and emerged mostly after administration of fourth dose E. coli-ASP (26.9%). Despite the characteristic differences between allergic and non-allergic group, it is not statistically significant.