fax: (902) 470-7216
meghan.pike@dal.ca
February 20th, 2021
Dear Dr. Newburger,
Thank you for considering our manuscript, entitled Asparaginase activity monitoring and management of asparaginase hypersensitivity reactions in Canada , for publication as a Research Article in Pediatric Blood and Cancer. Myself, Meghan Pike MD and my co-authors, Tamara MacDonald PharmD and Ketan Kulkarni MD FRCPC feel this study provides valuable information about the use of asparaginase and asparaginase activity level monitoring in Canada.
This survey study, which had responses from physicians in every province in Canada, identifies that only 39.2% of pediatric oncologists in Canada routinely measure asparaginase levels. The most common reason for this not knowing how to use levels clinically. There is also variation in the timing of levels and their target(s). The survey also identified inconsistency of use of Erwinia and the authors feel that consistent asparaginase activity level monitoring may decrease the frequency of switching asparaginase formulations from pegaspargase toErwinia, which is especially important in light of the current global Erwinia shortage.The information provided by this study informs us of the need for a pan-Canadian guideline regarding asparaginase activity level monitoring and management of asparaginase reactions, which the authors intend to develop.
This manuscript has not been submitted elsewhere nor has it been previously published. The authors do not have any conflict of interest relating to this study.
All authors have contributed to the manuscript in significant ways, have reviewed and agreed upon the manuscript content. Three potential reviewers who are experts in this field without any identified conflict of interest include Dr. Sunil Desai, Dr. Jim Whitlock, Dr. Sarah Alexander.
Sincerely,
Meghan Pike, MD
Corresponding Author