Optimising Asparaginase Use and Managing Hypersensitivity in A ustralasia—A Clinical Practice Guideline From the A ustralian and N ew Z ealand Children's Haematology/Oncology Group

BACKGROUND: Asparaginase is a critical component of modern multi-agent chemotherapy regimens for paediatric acute lymphoblastic leukaemia and lymphoblastic lymphoma, with inadequate exposure leading to inferior patient outcomes. OBJECTIVES: To develop a clinical practice guideline for the use of asparaginase products in the Australasian context. METHODS: This clinical practice guideline was developed following consultation and a review of the available published data and is designed to standardise treatment across the region. RESULTS: This paper reports the position of the Australian and New Zealand Children's Haematology/Oncology Group (ANZCHOG) on key areas including established and new asparaginase products and their use in Australasia, monitoring and interpretation of serum asparaginase activity, care in the setting of hypersensitivity and management of suboptimal asparagine depletion. CONCLUSIONS: This clinical practice guideline will assist clinicians in the Australasian region who provide care to children, adolescents and young adults receiving asparaginase therapy.