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27
Jul
New treatment to be recommended for ALL patients in England and Wales

written by

Leukaemia Care, Charity

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The National Institute for Health and Care Excellence (NICE) has this week published the final appraisal determination (FAD) recommending pegaspargase for clinical use for NHS patients with acute lymphoblastic leukaemia (ALL) in England and Wales. Pegaspargase, marketed by Shire as Oncaspar®, is to be recommended “as part of antineoplastic combination therapy” as an option “for treating acute lymphoblastic leukaemia in children, young people and adults” when they “have untreated newly diagnosed disease.”

ALL is a rapidly progressing form of leukaemia that affects B lymphocytes, which are the antibodies in your blood that help to fight infection and T lymphocytes that help B lymphocytes make antibodies to help fight infection. When someone has ALL the blood forming cell process is uncontrolled and creates too many lymphocytes, which means that the body cannot fight infection properly. Typical symptoms of ALL are fever, unusual bleeding and bruising, repeat infections, tiredness and anaemia. There are approximately 730 people diagnosed with ALL in England and Wales each year, with a high proportion of patients being children. 

The NICE appraisal committee (who review all of the data and information to decide if a drug should be used routinely by clinicians within the NHS) considered how well pegaspargase works for patients and whether it can be considered a valuable use of NHS resource in terms of cost. They also looked at evidence submitted by the company who make the drug and patient organisations, like Leukaemia CARE. The final appraisal determination, a document detailing how the appraisal committee decided to recommend a drug, describes how the committee took into account the huge emotional impact an ALL diagnosis has to a patient and their families and the importance of having as many available treatment options as possible.

Pegaspargase has been used as first line treatment for patients with ALL as standard practice for some time, a final recommendation from NICE would ensure this continues to be the case. Pegaspargase is a PEGylated version of a drug called asparaginase, which means due to its chemical make-up, it has a longer half-life than asparaginase. This means that patients do not need to receive it as often, making it a more convenient treatment option and therefore helping to improve patient quality of life.

Zack Pemberton Whiteley, Head of Campaigns and Advocacy at Leukaemia CARE comments:

“Although pegaspargase is already widely used in clinical practice, we are pleased that NICE have recognised its clinical benefit for the treatment of patients with acute lymphoblastic leukaemia. ALL is a rapidly progressing disease and it is important that there are as many available treatment options as possible. It is our hope that this preliminary recommendation will soon translate into final guidance, which would provide continued access to this treatment on the NHS.”