Scientific Letter
Activity of Erwinia-asparaginase after anaphylactic reaction to Peg-asparaginase
Actividad de Erwinia-asparraginasa tras reacción anafiláctica a Peg-asparraginasa
Read
4668
Timeswas read the article
2373
Total PDF
2295
Total HTML
Share statistics
array:25 [ "pii" => "S2341287919300092" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.03.012" "estado" => "S300" "fechaPublicacion" => "2019-03-01" "aid" => "2425" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2018" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "An Pediatr (Barc). 2019;90:187-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 770 "formatos" => array:3 [ "EPUB" => 66 "HTML" => 483 "PDF" => 221 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S1695403318301450" "issn" => "16954033" "doi" => "10.1016/j.anpedi.2018.03.013" "estado" => "S300" "fechaPublicacion" => "2019-03-01" "aid" => "2425" "copyright" => "Asociación Española de Pediatría" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "An Pediatr (Barc). 2019;90:187-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2082 "formatos" => array:3 [ "EPUB" => 168 "HTML" => 1329 "PDF" => 585 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científica</span>" "titulo" => "Actividad de <span class="elsevierStyleItalic">Erwinia</span>-asparraginasa tras reacción anafiláctica a Peg-asparraginasa" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "187" "paginaFinal" => "188" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Activity of <span class="elsevierStyleItalic">Erwinia</span>-asparaginase after anaphylactic reaction to Peg-asparaginase" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Maria Micaela Viña Romero, Sara García Gil, Gloria Julia Nazco Casariego, Javier Merino Alonso, Fernando Gutiérrez Nicolás" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Maria Micaela" "apellidos" => "Viña Romero" ] 1 => array:2 [ "nombre" => "Sara" "apellidos" => "García Gil" ] 2 => array:2 [ "nombre" => "Gloria Julia" "apellidos" => "Nazco Casariego" ] 3 => array:2 [ "nombre" => "Javier" "apellidos" => "Merino Alonso" ] 4 => array:2 [ "nombre" => "Fernando" "apellidos" => "Gutiérrez Nicolás" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287919300092" "doi" => "10.1016/j.anpede.2018.03.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919300092?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318301450?idApp=UINPBA00005H" "url" => "/16954033/0000009000000003/v2_202009040640/S1695403318301450/v2_202009040640/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2341287919300109" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.03.013" "estado" => "S300" "fechaPublicacion" => "2019-03-01" "aid" => "2432" "copyright" => "Asociación Española de Pediatría" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "An Pediatr (Barc). 2019;90:188-90" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1718 "formatos" => array:3 [ "EPUB" => 84 "HTML" => 1348 "PDF" => 286 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Fulminant acute cerebellitis: An under-diagnosed condition?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "188" "paginaFinal" => "190" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cerebelitis aguda fulminante, ¿una entidad infradiagnosticada?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1106 "Ancho" => 1867 "Tamanyo" => 175402 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Cranial CT scan, axial plane: subcortical hypodensity in left cerebellar hemisphere with nonspecific appearance. (B) Head MRI, T2-weighted axial view: hyperintensity in both cerebellar hemispheres with restricted diffusion and cortical enhancement after administration of contrast. (C) Cranial CT scan, axial plane: evidence of progression of cerebellar ischaemia associated with swelling and mass effect and with descent of the cerebellar tonsils to the foramen magnum and raised supratentorial ventricle.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Molina Corbacho, Fernando Martín Birlanga, Nerea Sarrión Sos, Pablo Gargallo Tatay, Miguel Tomás Vila" "autores" => array:5 [ 0 => array:2 [ "nombre" => "María" "apellidos" => "Molina Corbacho" ] 1 => array:2 [ "nombre" => "Fernando" "apellidos" => "Martín Birlanga" ] 2 => array:2 [ "nombre" => "Nerea" "apellidos" => "Sarrión Sos" ] 3 => array:2 [ "nombre" => "Pablo" "apellidos" => "Gargallo Tatay" ] 4 => array:2 [ "nombre" => "Miguel" "apellidos" => "Tomás Vila" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403318301528" "doi" => "10.1016/j.anpedi.2018.03.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318301528?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919300109?idApp=UINPBA00005H" "url" => "/23412879/0000009000000003/v1_201903020636/S2341287919300109/v1_201903020636/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2341287919300043" "issn" => "23412879" "doi" => "10.1016/j.anpede.2018.02.014" "estado" => "S300" "fechaPublicacion" => "2019-03-01" "aid" => "2422" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2019;90:180-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2111 "formatos" => array:3 [ "EPUB" => 72 "HTML" => 1671 "PDF" => 368 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Implementation of a low FODMAP diet for functional abdominal pain" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "180" "paginaFinal" => "186" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Implantación de la dieta baja en FODMAP para el dolor abdominal funcional" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3137 "Ancho" => 2083 "Tamanyo" => 371649 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diary of symptoms and bowel movements.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Luisa Baranguán Castro, Ignacio Ros Arnal, Ruth García Romero, Gerardo Rodríguez Martínez, Eduardo Ubalde Sainz" "autores" => array:5 [ 0 => array:2 [ "nombre" => "María Luisa" "apellidos" => "Baranguán Castro" ] 1 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Ros Arnal" ] 2 => array:2 [ "nombre" => "Ruth" "apellidos" => "García Romero" ] 3 => array:2 [ "nombre" => "Gerardo" "apellidos" => "Rodríguez Martínez" ] 4 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Ubalde Sainz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403318301358" "doi" => "10.1016/j.anpedi.2018.02.025" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403318301358?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919300043?idApp=UINPBA00005H" "url" => "/23412879/0000009000000003/v1_201903020636/S2341287919300043/v1_201903020636/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Activity of <span class="elsevierStyleItalic">Erwinia</span>-asparaginase after anaphylactic reaction to Peg-asparaginase" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "187" "paginaFinal" => "188" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Maria Micaela Viña Romero, Sara García Gil, Gloria Julia Nazco Casariego, Javier Merino Alonso, Fernando Gutiérrez Nicolás" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Maria Micaela" "apellidos" => "Viña Romero" "email" => array:1 [ 0 => "kellyviro@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Sara" "apellidos" => "García Gil" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Gloria Julia" "apellidos" => "Nazco Casariego" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Javier" "apellidos" => "Merino Alonso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Fernando" "apellidos" => "Gutiérrez Nicolás" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Farmacia, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Tenerife, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Farmacia, Complejo Hospitalario Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Actividad de <span class="elsevierStyleItalic">Erwinia</span>-asparraginasa tras reacción anafiláctica a Peg-asparraginasa" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSmallCaps">l</span>-Asparaginase (<span class="elsevierStyleSmallCaps">l</span>-ASP) is one of the cornerstones of the treatment of paediatric acute lymphoblastic leukaemia (ALL).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It is used with the aim of depleting circulating asparagine, which induces apoptosis in malignant lymphoid cells indirectly by impeding protein synthesis.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> This systemic depletion of asparagine requires an adequate level of <span class="elsevierStyleSmallCaps">l</span>-ASP activity, which is currently considered to be a level exceeding 100<span class="elsevierStyleHsp" style=""></span>IU/L.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Several <span class="elsevierStyleSmallCaps">l</span>-ASP agents are currently available, each with different pharmacokinetic characteristics. Two are derived from <span class="elsevierStyleItalic">Escherichia coli</span>, including the enzyme in its native form (<span class="elsevierStyleItalic">E. coli</span>-ASP) and the pegylated enzyme (PEG-ASP); and 1 is derived from <span class="elsevierStyleItalic">Erwinia chrysanthemi</span> (<span class="elsevierStyleItalic">Erwinia</span>-ASP). Most current protocols recommend the use of the pegylated enzyme derived from <span class="elsevierStyleItalic">E. coli</span>, while the enzyme derived from <span class="elsevierStyleItalic">Erwinia</span> is used as second- or third-line treatment in cases of hypersensitivity, which develops in up to 22% of patients.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> However, the hypersensitivity reaction is not the only response mediated by the immune system that limits the use of <span class="elsevierStyleSmallCaps">l</span>-ASP, as the phenomenon known as silent inactivation has also been described in the literature (in 8%–10% of cases).<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Our aim in this work was two-fold: on one hand, we sought to demonstrate that routine measurement of <span class="elsevierStyleSmallCaps">l</span>-ASP activity is feasible in everyday clinical practice in hospital settings, and on the other, to present a case that shows that it is possible to use <span class="elsevierStyleItalic">Erwinia</span>-ASP following a hypersensitivity reaction to PEG-ASP and to maintaining adequate activity levels as long as the dosing schedule established for this form of <span class="elsevierStyleSmallCaps">l</span>-ASP is followed rigorously.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We present the case of a male patient aged 10 years with an ALL diagnosis that was treated according to the United Kingdom Acute Lymphoblastic Leukaemia (UKALL) protocol. At 20 months, the patient experienced a relapse that was treated according to the 2015 LAL/SEHOP-PETHEMA protocol version 1.0 for a first relapse. The patient developed a hypersensitivity reaction following the initial dose of PEG-ASP, so, in adherence to current clinical guidelines, treatment was switched to <span class="elsevierStyleItalic">Erwinia</span>-ASP. Although the source of the protein was different, there was a risk of cross-reactivity that could involve either another hypersensitivity reaction or a silent inactivation of the new form of asparaginase. For these reason, we decided to monitor the levels of asparaginase activity at every through (every 48<span class="elsevierStyleHsp" style=""></span>h, <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The patient did not exhibit a hypersensitivity reaction after receiving the first dose of <span class="elsevierStyleItalic">Erwinia</span>-ASP. We only detected a suboptimal level of activity (<100<span class="elsevierStyleHsp" style=""></span>IU/L) in the third through (28.8<span class="elsevierStyleHsp" style=""></span>IU/L), which we attributed to a 24-h delay in the administration of the dose (at 72<span class="elsevierStyleHsp" style=""></span>h instead of 48<span class="elsevierStyleHsp" style=""></span>h) because it was Christmas day. The levels of activity returned to normal in subsequent cycles. Therefore, to date there is no evidence of silent inactivation taking place.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Our results show that <span class="elsevierStyleItalic">Erwinia</span>-ASP can be effective in the treatment of patients that have experienced a hypersensitivity reaction to PEG-ASP. Based on our experience, we can conclude that the use of <span class="elsevierStyleItalic">Erwinia</span>-ASP requires strict adherence to the administration of the drug every 48<span class="elsevierStyleHsp" style=""></span>h to ensure adequate levels of activity. To conclude, we would like to underscore that monitoring these levels makes it possible for clinicians to ascertain the correct use of asparaginase.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Viña Romero MM, Gil SG, Casariego GJ, Alonso JM, Nicolás FG. Actividad de <span class="elsevierStyleItalic">Erwinia</span>-asparraginasa tras reacción anafiláctica a Peg-asparraginasa. An Pediatr (Barc). 2019;90:187–188.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSmallCaps">l</span>-ASP: <span class="elsevierStyleSmallCaps">l</span>-asparaginase.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Trough day \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleSmallCaps">l</span>-ASP (IU/L) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">+2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">385.14 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">+2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">126.71<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">+3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.83 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">+2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">370.62 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">+2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">221.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1977055.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Sample not stored under optimal conditions.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Trough values of plasma <span class="elsevierStyleSmallCaps">l</span>-ASP.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleSmallCaps">l</span>-Asparaginase treatment in acute lymphoblastic leukemia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Pieters" 1 => "P. Hunger" 2 => "J. Boos" 3 => "C. Rizzari" 4 => "L. Silverman" 5 => "A. Baruchel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.25489" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2011" "volumen" => "117" "paginaInicial" => "238" "paginaFinal" => "249" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20824725" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Asparaginase activity levels and monitoring in patients with acute lymphoblastic leukemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W. Salzer" 1 => "B. Bostrom" 2 => "Y. Messinger" 3 => "A.J. Perissinotti" 4 => "B. Marini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Leuk Lymphoma" "fecha" => "2017" "volumen" => "18" "paginaInicial" => "1" "paginaFinal" => "10" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8580810" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[in Spanish]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update on <span class="elsevierStyleSmallCaps">l</span>-asparaginase treatment in paediatrics" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C Moscardó Guilleme" 1 => "R Fernández Delgado" 2 => "J Sevilla Navarro" 3 => "I Astigarraga Aguirre" 4 => "S Rives Solà" 5 => "J Sánchez de Toledo Codina" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2013" "volumen" => "79" "paginaInicial" => "329.e1" "paginaFinal" => "329.e11" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Population pharmacokinetics to model the time-varying clearance of the PEGylated Asparaginase Oncaspar<span class="elsevierStyleSup">®</span> in children with acute lymphoblastic leukemia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Würthwein" 1 => "C. Lanvers-Kaminsky" 2 => "G. Hempel" 3 => "S. Gastine" 4 => "A. Möricke" 5 => "M. Schrappe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s13318-017-0410-5" "Revista" => array:7 [ "tituloSerie" => "Eur J Drug Metab Pharmacokinet" "fecha" => "2017" "volumen" => "42" "paginaInicial" => "955" "paginaFinal" => "963" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28349335" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1470204511700572" "estado" => "S300" "issn" => "14702045" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A prospective study on drug monitoring of PEGasparaginase and Erwinia asparaginase and asparaginase antibodies in pediatric acute lymphoblastic leukemia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.H. Tong" 1 => "R. Pieters" 2 => "G.J. Kaspers" 3 => "D.M. te Loo" 4 => "M.B. Bierings" 5 => "C. van den Bos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2013-10-534347" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2014" "volumen" => "123" "paginaInicial" => "2026" "paginaFinal" => "2033" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24449211" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009000000003/v1_201903020636/S2341287919300092/v1_201903020636/en/main.assets" "Apartado" => array:4 [ "identificador" => "38181" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009000000003/v1_201903020636/S2341287919300092/v1_201903020636/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287919300092?idApp=UINPBA00005H" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 10 | 20 |
| 2024 October | 60 | 49 | 109 |
| 2024 September | 61 | 38 | 99 |
| 2024 August | 48 | 54 | 102 |
| 2024 July | 33 | 38 | 71 |
| 2024 June | 38 | 33 | 71 |
| 2024 May | 28 | 34 | 62 |
| 2024 April | 36 | 41 | 77 |
| 2024 March | 24 | 19 | 43 |
| 2024 February | 33 | 31 | 64 |
| 2024 January | 29 | 14 | 43 |
| 2023 December | 53 | 27 | 80 |
| 2023 November | 50 | 36 | 86 |
| 2023 October | 35 | 21 | 56 |
| 2023 September | 25 | 36 | 61 |
| 2023 August | 25 | 39 | 64 |
| 2023 July | 25 | 54 | 79 |
| 2023 June | 27 | 38 | 65 |
| 2023 May | 32 | 38 | 70 |
| 2023 April | 13 | 23 | 36 |
| 2023 March | 31 | 49 | 80 |
| 2023 February | 31 | 41 | 72 |
| 2023 January | 15 | 15 | 30 |
| 2022 December | 33 | 40 | 73 |
| 2022 November | 37 | 34 | 71 |
| 2022 October | 48 | 48 | 96 |
| 2022 September | 30 | 27 | 57 |
| 2022 August | 32 | 65 | 97 |
| 2022 July | 27 | 40 | 67 |
| 2022 June | 31 | 34 | 65 |
| 2022 May | 35 | 45 | 80 |
| 2022 April | 30 | 28 | 58 |
| 2022 March | 41 | 58 | 99 |
| 2022 February | 24 | 60 | 84 |
| 2022 January | 27 | 57 | 84 |
| 2021 December | 38 | 65 | 103 |
| 2021 November | 31 | 55 | 86 |
| 2021 October | 53 | 79 | 132 |
| 2021 September | 30 | 60 | 90 |
| 2021 August | 24 | 56 | 80 |
| 2021 July | 17 | 30 | 47 |
| 2021 June | 31 | 77 | 108 |
| 2021 May | 22 | 59 | 81 |
| 2021 April | 113 | 119 | 232 |
| 2021 March | 43 | 20 | 63 |
| 2021 February | 22 | 29 | 51 |
| 2021 January | 29 | 27 | 56 |
| 2020 December | 20 | 26 | 46 |
| 2020 November | 23 | 27 | 50 |
| 2020 October | 16 | 24 | 40 |
| 2020 September | 23 | 21 | 44 |
| 2020 August | 14 | 5 | 19 |
| 2020 July | 15 | 15 | 30 |
| 2020 June | 18 | 3 | 21 |
| 2020 May | 21 | 17 | 38 |
| 2020 April | 21 | 9 | 30 |
| 2020 March | 18 | 11 | 29 |
| 2020 February | 24 | 10 | 34 |
| 2020 January | 24 | 13 | 37 |
| 2019 December | 39 | 23 | 62 |
| 2019 November | 17 | 5 | 22 |
| 2019 October | 15 | 9 | 24 |
| 2019 September | 32 | 12 | 44 |
| 2019 August | 21 | 23 | 44 |
| 2019 July | 48 | 31 | 79 |
| 2019 June | 101 | 18 | 119 |
| 2019 May | 63 | 17 | 80 |
| 2019 April | 37 | 32 | 69 |
| 2019 March | 69 | 27 | 96 |
| 2019 February | 6 | 5 | 11 |
Show all
