Navigating Asparaginase-Based Therapies in Adult, Adolescent, and Young Adult Acute Lymphoblastic Leukemia: Evidence-Based Guidance for the Oncology Pharmacist

This activity was originally presented as a Post-HOPA Virtual Symposium.

Program Description

Asparaginase therapy remains a critical component of treatment for acute lymphoblastic leukemia (ALL) across pediatric, adolescent and young adult (AYA), and adult populations, yet its optimal use continues to present significant clinical challenges. Sustained asparagine depletion is essential for achieving remission and improved survival outcomes; however, premature discontinuation of therapy due to misclassified reactions can compromise treatment efficacy. Oncology pharmacists play a vital role in differentiating reaction types based on timing, symptom patterns, and clinical presentation, yet inconsistent grading and monitoring practices can hinder appropriate decision making. While therapeutic drug monitoring (TDM) offers an evidence-based strategy to distinguish immune-mediated inactivation from other reactions and guide treatment decisions, its implementation in adult and AYA ALL remains inconsistent. This case-based panel discussion will explore practical approaches for differentiating asparaginase-related reactions, optimizing exposure through TDM, and ensuring effective formulation transitions to maintain treatment continuity across pediatric, AYA, and adult populations. Faculty will review real-world cases highlighting hypersensitivity management, toxicity mitigation, and the integration or switch of asparaginase formulations. Through expert commentary and interactive discussion, participants will gain tools to apply evidence-informed strategies for individualized therapy, reduce unnecessary treatment interruptions, and contribute to consistent, high-quality asparaginase use in adult and AYA ALL care.

Target audience: Oncology pharmacists
Type of activity: Application
Release date: May 18, 2026
Expiration date: May 18, 2027
Learner level: Advanced
Time to complete activity: 1.25 hour
Fee: Free

Educational Objectives

At the completion of this activity, participants will be able to:

• Differentiate between immunologic hypersensitivity reactions from ammonia-mediated and cytokine-type infusion reactions using clinical presentation, timing, and mechanistic features
• Break down therapeutic drug monitoring results to guide patient-specific decisions regarding continuation, dose modification, or formulation switching
• Factor patient-specific factors into evidence-based decisions regarding formulation selection and toxicity management in the care of adolescents and young adults with acute lymphoblastic leukemia
• Apply evidence-informed criteria to guide appropriate formulation transitions while minimizing unnecessary patient burden and preserving therapeutic intent

Accreditation

Pharmacy Times Continuing Education™ is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.25 contact hours (0.125CEU) under the ACPE universal activity number 0290-0000-26-146-H01-P The activity is available for CE credit through May 18, 2027

Instructions for Completing the Activity and Receiving CPE Credit

To receive CPE credit, participants must complete the pretest, view the activity in its entirety, complete the posttest, and complete the online activity evaluation. After successful completion of the online activity evaluation, you can submit your credit to CPE Monitor. You may view your credit within 48 hours at www.mycpemonitor.net. All participants must request credit before the activity expiration date. CE credit will not be issued after this date.

Faculty

Anthony J. Perissinotti, PharmD, BCOP , has the following relevant financial relationships with ineligible companies to disclose:

Consultant: Amgen, Servier, Jazz Pharmaceuticals

Shawn P. Griffin, PharmD, BCOP, has the following relevant financial relationships with ineligible companies to disclose:

Speakers Bureau: Geron

Pharmacy Times Continuing Education™ Planning Staff—Jim Palatine, RPh, MBA; Daphne Davis, PharmD, BCOP; Macara Desai; Susan Pordon; Brianna Winters; and Chloe Taccetta have no relevant financial relationships with ineligible companies to disclose.

Any relevant financial relationships listed for these individuals have been mitigated.

At least one anonymous peer reviewer was used as part of content validation and conflict resolution. The peer reviewer has no relevant financial relationships with ineligible companies to disclose.

Educational Disclaimer

Continuing professional education activities are offered solely for educational purposes and do not constitute any form of professional advice or referral. Discussions concerning drugs, dosages, and procedures may reflect the clinical experience of the author(s) or be derived from the professional literature or other sources and may suggest uses that are investigational in nature and not approved by the labeling or indications. Participants are encouraged to refer to primary references or full prescribing information resources.

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