Measurement of pegaspargase levels
All but 3 respondents reported using primarily pegasparaginase intravenously at their centre. Out of the 3 that were unsure, 2 respondents were from Eastern Canadian centres, and one from a Western Canadian centre.
Twenty respondents (39.2%) reported routinely measuring levels. These respondents were mostly from Eastern and Atlantic Canada. The most common reasons for not routinely measuring asparaginase levels was that respondents were unsure how to use levels clinically (relative frequency=25.5%), were unsure if this was required (relative frequency=21.6%) or felt there was no centre/laboratory available to send the samples for analysis (relative frequency=19.6%). Other reasons included cost (relative frequency=11.8%) and overall lack of knowledge regarding how and when to send levels (relative frequency=13.7% for each).
At hospitals that measure asparaginase levels, levels are reviewed primarily by clinicians (including subspecialty residents, nurse practitioners and physicians) (relative frequency=45.1%), but also by pharmacists (relative frequency=19.6%).
When asked regarding timing of levels, Day 6-7 was the most popular selection with a relative frequency of 29.4%. Day 0 was selected with a relative frequency of 9.8%, Day 2 with a relative frequency of 1.9% and Day 14 with a relative frequency of 9.8% (see Table 2).