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Mature IGF-2 primarily exists in two forms: bound in a 50 kDa binary complex with IGFBP-3 (IGF Binding Protein-3) or in a 150 kDa ternary complex with IGFBP-3 and ALS (Acid-Labile Subunit)

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These patients had a superior EFS if their asparaginase preparation was changed.[24] Patients who were treated with pegaspargase appear to have lower levels of silent inactivation ( 0.01%) and/or high-risk cytogenetics were randomly assigned to receive either a standard-intensity or an augmented BFM chemotherapy backbone.[86] The 10-year EFS rate was 87.1% for patients assigned to the augmented chemotherapy backbone, compared with 82.1% for those assigned the standard-intensity chemotherapy backbone ( P = .09)