Desensitization

protocol should not be used in acute lymphoblastic leukemia patients with silent inactivation of PEGasparaginase Asparaginase antibodies (AAAs) neutralize asparaginase and are often accompanied by a clinically overt allergic reaction, but in a proportion of the patients these antibod-ies occur without any signs of hypersensitivity, termed as silent inactivation.1,2 Vrooman et al. and Panosyan et al. showed that children with silent inactivation of native E.Coli asparaginase had poorer outcomes as they were not switched to another asparaginase preparation that retained its activity.3,4 A case report described the successful use of desensitization courses in a patient with severe hypersensi-tivity reaction to native E.coli asparaginase.5 Therefore, we analyzed children with newly diagnosed acute lym