Acute Lymphoblastic Leukemia: Nursing Notes on Asparaginase Hypersensitivity and Silent Inactivation

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Release Date: December 23, 2021
Expiration Date: December 23, 2022

Expected time to complete this activity as designed: 60 minutes

There are no fees for participating in or receiving credit for this online activity.

This activity was previously presented as a webinar with live Q&A in December of 2021. Please note: If you participated in the live webinar, you are ineligible to receive an additional 1.0 contact hour of credit and may not re-submit for credit previously awarded.

Program Overview

Outcomes in acute lymphoblastic leukemia (ALL) have improved significantly for children over the past decades, due primarily in part to multi-agent chemotherapy. Asparaginases are a cornerstone of treatment for ALL, a critical component of many treatment protocols, and is used for remission induction and intensification treatment. Despite this success, hypersensitivity and silent inactivation remain a significant problem with treatment, so it is critical to rapidly identify when this occurs and know how to manage it. This activity will provide an interactive opportunity to test your knowledge and learn how to recognize, manage, and treat these complications.

Target Audience

This activity is designed for nurses who provide care to pediatric and young adult patients with acute myeloid leukemia.

Learning Objectives

Upon completion of this educational activity, participants should be able to:

  • Discuss the history of asparaginase in the treatment of pediatric and adolescent and young adult (AYA) patients with ALL
  • Describe the pharmacokinetic properties, routes of administration, and adverse reactions of ASNase and PEG ASNase formulations, including approved and emerging agents
  • Recount the pathophysiology of the hypersensitivity and inactivation process
  • Identify optimal methods of measuring subclinical hypersensitivity or silent inactivation
  • Discuss the treatment of subclinical hypersensitivity or silent inactivation to E. coli-derived asparaginase, including agents recently approved and in late-stage clinical trials
  • Implement optimal approaches for nurse monitoring, hypersensitivity reaction management, and patient/family education for pediatric and AYA patients with ALL and their families


Acute Lymphoblastic Leukemia: Nursing Note on Asparaginase Hypersensitivity and Silent Inactivation – Katelyn Oranges, MSN, CRNP, CPHON, and Joseph Sciasci, PharmD, BCOP

Instructions for Participation and Credit

This activity is eligible for credit through December 23, 2022. After this date, this activity will expire and no further credit will be awarded.

  1. Read the target audience, learning objectives, and faculty disclosures.
  2. You may be asked to complete a short pre-test before accessing the educational content. This must be completed in order to move forward in the activity.
  3. Complete the educational content as designed.
  4. Complete the post-test. To receive a certificate, you must receive a passing score of 70%.
  5. Complete the activity evaluation survey to provide feedback and information useful for future programming.
  6. Certificates for CNE may be printed immediately after successfully completing the post-test and activity evaluation.

Faculty Biographies

Katelyn Oranges, MSN, CRNP, CPHON
Hematologic Malignancies Nurse Practitioner
The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania

Katelyn Oranges earned her BSN and MSN at the University of Pennsylvania in Philadelphia. She is a Certified Pediatric Hematology/ Oncology Nurse (CPHON), a Certified Pediatric Nurse Practitioner-Acute Care (CPNP-AC), and is certified in Pediatric Advanced Life Support (PALS) at Children’s Hospital of Philadelphia (CHOP). As a nurse practitioner, Ms. Oranges’ role is to work with the medical and nursing teams to provide clinical and supportive care to inpatient pediatric oncology patients and their families.

As a member of the Hematologic Malignancy group at CHOP, she primarily works with leukemia and lymphoma patients and builds strong relationships with patients and their families. Ms. Oranges is also part of the multidisciplinary team that works to provide all-inclusive education for newly diagnosed patients and their families as they navigate their diagnosis, underlying disease, and the treatment to be provided. She values the time spent with a family teaching them about their child’s diagnosis, treatment, and side effects of therapy. Ms. Oranges is interested in improving symptom management of the patients receiving chemotherapy, and integrating comprehensive supportive care into the medical care provided. In addition, she educates staff nurses and nurse practitioner students, and continues to strive to provide the best care to patients and families.

Joseph Sciasci, PharmD, BCOP
Clinical Pharmacy Specialist
St. Jude Children’s Research Hospital
Memphis, Tennessee

Dr. Joseph Sciasci received his PharmD at Philadelphia College of Pharmacy, followed by his PGY1 Pharmacy Practice Residency at Children’s Hospital of Wisconsin, Milwaukee, and his PGY2 Oncology Practice Residency at St. Jude Children’s Research Hospital, Memphis, Tennessee. He is currently a Clinical Pharmacy Specialist at St. Jude Children’s Research Hospital.

Dr. Sciasci is a Board Certified Pharmacotherapy Specialist (BCPS) and a Board Certified Oncology Pharmacist (BCOP). He is a member of the Children’s Oncology Group, Pediatric Pharmacy Association, and the Hematology/Oncology Pharmacists Association. He is a recipient of the 2020 Clinical Care Improvement Award for Clinical Pharmacy Services, St. Jude Children’s Research Hospital.


MediCom Worldwide, Inc. is approved by the California Board of Registered Nursing, Provider Number CEP11380. MediCom designates this CNE activity for 1.0 contact hour. Program Number: 21-046-152


As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Pharmacy Education (ACPE) and California State Board of Registered Nursing, MediCom Worldwide, Inc. requires everyone who is in a position to control the content of an accredited continuing education activity to disclose all financial relationships with any ineligible company. The ACCME defines “ineligible companies” as any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products by or on patients. A relevant relationship exists if a financial relationship in any amount exists between the person in control of content and an ineligible company; the financial relationship existed during the past 24 months and the content of the education is related to the products of an ineligible company with whom the person has a financial relationship. MediCom will identify mitigation strategies for all persons with relevant financial relationships who control content of the educational activity.

Faculty Disclosures

Katelyn Oranges, faculty for this educational activity, has no relevant financial relationship(s) with ineligible companies to disclose.

Dr. Joseph Sciasci, faculty for this educational activity, has no relevant financial relationship(s) with ineligible companies to disclose.

Unapproved Product Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses of products or devices.

Planning Committee

Joan Meyer, RN, MHA, Executive Director, Isabelle Vacher, Vice President of Educational Strategy, and Andrea Mathis, Project Manager, planners for this educational activity, have no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.

Peer Reviewer

Peer reviewer(s) for this educational activity have no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.

If you have any questions or concerns regarding this activity, please contact MediCom Worldwide, Inc. at 1-800-408-4242 or email us at [email protected]

Provided by MediCom Worldwide, Inc.
This activity is supported by educational grants from Jazz Pharmaceuticals and Servier Pharmaceuticals, LLC

©2021 MediCom Worldwide, Inc., 660 Newtown Yardley Rd, Suite 203 · Newtown, PA 18940, 800-408-4242. No portion of this material may be copied or duplicated without the expressed permission of MediCom Worldwide, Inc.

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