Cochrane · systematic review · CD014570
PEG‐asparaginase treatment regimens for acute lymphoblastic leukaemia in children: a network meta‐analysis
Lynggaard, LS, Rank, CU, Als-Nielsen, B, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
Childhood CancerAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
19
No studies
2
Included studies
NR
No studies 2 · 9.5%Ungraded 0 · 0%Very low 0 · 0%Low 9 · 42.9%Moderate 10 · 47.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings table ‐ Intermittent PEG‐asparaginase treatment (8 doses, 1000 IU/m2, IM) compared to continuous PEG‐asparaginase treatment (15 doses, 1000 IU/m2, IM) for children and adolescents (< 18 years of age) with first‐line ALL
Population: children and adolescents (< 18 years of age) with first‐line ALL
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival ‐ not reported Summary of findings table ‐ Intermittent PEG‐asparaginase treatment (8 doses, 1000 IU/m2, IM) vs continuous PEG‐asparaginase treatment (15 doses, 1000 IU/m2, IM) | no estimate extracted | NR | No studies |
Event‐free survival Summary of findings table ‐ Intermittent PEG‐asparaginase treatment (8 doses, 1000 IU/m2, IM) vs continuous PEG‐asparaginase treatment (15 doses, 1000 IU/m2, IM) | RR 1.01 [0.97, 1.06] | 1 study · 625 participants | Moderate Downgraded: imprecision |
Hypersensitivity Summary of findings table ‐ Intermittent PEG‐asparaginase treatment (8 doses, 1000 IU/m2, IM) vs continuous PEG‐asparaginase treatment (15 doses, 1000 IU/m2, IM) | RR 0.64 [0.21, 1.93] | 1 study · 625 participants | Low Downgraded: imprecision |
Pancreatitis Summary of findings table ‐ Intermittent PEG‐asparaginase treatment (8 doses, 1000 IU/m2, IM) vs continuous PEG‐asparaginase treatment (15 doses, 1000 IU/m2, IM) | RR 0.31 [0.12, 0.75] | 1 study · 625 participants | Moderate Downgraded: imprecision |
Thromboembolism Summary of findings table ‐ Intermittent PEG‐asparaginase treatment (8 doses, 1000 IU/m2, IM) vs continuous PEG‐asparaginase treatment (15 doses, 1000 IU/m2, IM) | RR 0.55 [0.22, 1.36] | 1 study · 625 participants | Low Downgraded: imprecision |
Osteonecrosis Summary of findings table ‐ Intermittent PEG‐asparaginase treatment (8 doses, 1000 IU/m2, IM) vs continuous PEG‐asparaginase treatment (15 doses, 1000 IU/m2, IM) | RR 0.68 [0.35, 1.32] | 1 study · 625 participants | Low Downgraded: imprecision |
Asparaginase‐associated toxicity Summary of findings table ‐ Intermittent PEG‐asparaginase treatment (8 doses, 1000 IU/m2, IM) vs continuous PEG‐asparaginase treatment (15 doses, 1000 IU/m2, IM) | RR 0.53 [0.35, 0.78] | 1 study · 625 participants | Moderate Downgraded: imprecision |
Summary of findings table ‐ Low‐risk with additional PEG‐asp (6 doses, 2500 IU/m2, IV) compared to low‐risk standard (2 doses, 2500 IU/m2, IV) for children and adolescents (< 18 years of age) with first‐line ALL
Population: children and adolescents (< 18 years of age) with first‐line ALL
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Summary of findings table ‐ Low‐risk with additional PEG‐asp (6 doses, 2500 IU/m2, IV) vs low‐risk standard (2 doses, 2500 IU/m2, IV) | RR 0.99 [0.98, 1] | 1 study · 1857 participants | Moderate Downgraded: imprecision |
Event‐free survival Summary of findings table ‐ Low‐risk with additional PEG‐asp (6 doses, 2500 IU/m2, IV) vs low‐risk standard (2 doses, 2500 IU/m2, IV) | RR 1.01 [0.99, 1.04] | 1 study · 1857 participants | Moderate Downgraded: imprecision |
Hypersensitivity Summary of findings table ‐ Low‐risk with additional PEG‐asp (6 doses, 2500 IU/m2, IV) vs low‐risk standard (2 doses, 2500 IU/m2, IV) | RR 12.05 [5.27, 27.58] | 1 study · 1850 participants | Moderate Downgraded: imprecision |
Pancreatitis Summary of findings table ‐ Low‐risk with additional PEG‐asp (6 doses, 2500 IU/m2, IV) vs low‐risk standard (2 doses, 2500 IU/m2, IV) | RR 4.84 [2.15, 10.85] | 1 study · 1850 participants | Moderate Downgraded: imprecision |
Thromboembolism ‐ not reported Summary of findings table ‐ Low‐risk with additional PEG‐asp (6 doses, 2500 IU/m2, IV) vs low‐risk standard (2 doses, 2500 IU/m2, IV) | no estimate extracted | NR | No studies |
Osteonecrosis Summary of findings table ‐ Low‐risk with additional PEG‐asp (6 doses, 2500 IU/m2, IV) vs low‐risk standard (2 doses, 2500 IU/m2, IV) | RR 1.65 [0.91, 3] | 1 study · 1850 participants | Low Downgraded: imprecision |
Asparaginase‐associated toxicity Summary of findings table ‐ Low‐risk with additional PEG‐asp (6 doses, 2500 IU/m2, IV) vs low‐risk standard (2 doses, 2500 IU/m2, IV) | RR 4.49 [3.05, 6.59] | 1 study · 1850 participants | Moderate Downgraded: imprecision |
Summary of findings table ‐ Calaspargase (11 doses, 2500 IU/m2, IV) compared to PEG‐asparaginase (16 doses, 2500 IU/m2, IV) for children and adolescents (< 18 years of age) with first‐line ALL
Population: children and adolescents (< 18 years of age) with first‐line ALL
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Summary of findings table ‐ Calaspargase (11 doses, 2500 IU/m2, IV) vs PEG‐asparaginase (16 doses, 2500 IU/m2, IV) | no estimate extracted | 1 study · 239 participants | Moderate Downgraded: imprecision |
Event‐free survival Summary of findings table ‐ Calaspargase (11 doses, 2500 IU/m2, IV) vs PEG‐asparaginase (16 doses, 2500 IU/m2, IV) | RR 1.06 [0.97, 1.16] | 1 study · 239 participants | Moderate Downgraded: imprecision |
Hypersensitivity Summary of findings table ‐ Calaspargase (11 doses, 2500 IU/m2, IV) vs PEG‐asparaginase (16 doses, 2500 IU/m2, IV) | RR 1.17 [0.64, 2.13] | 1 study · 223 participants | Low Downgraded: imprecision |
Pancreatitis Summary of findings table ‐ Calaspargase (11 doses, 2500 IU/m2, IV) vs PEG‐asparaginase (16 doses, 2500 IU/m2, IV) | RR 0.85 [0.47, 1.52] | 1 study · 223 participants | Low Downgraded: imprecision |
Thromboembolism Summary of findings table ‐ Calaspargase (11 doses, 2500 IU/m2, IV) vs PEG‐asparaginase (16 doses, 2500 IU/m2, IV) | RR 0.83 [0.48, 1.42] | 1 study · 223 participants | Low Downgraded: imprecision |
Osteonecrosis Summary of findings table ‐ Calaspargase (11 doses, 2500 IU/m2, IV) vs PEG‐asparaginase (16 doses, 2500 IU/m2, IV) | RR 0.63 [0.15, 2.56] | 1 study · 223 participants | Low Downgraded: imprecision |
Asparaginase‐associated toxicity Summary of findings table ‐ Calaspargase (11 doses, 2500 IU/m2, IV) vs PEG‐asparaginase (16 doses, 2500 IU/m2, IV) | RR 1 [0.71, 1.4] | 1 study · 223 participants | Low Downgraded: imprecision |