Cited by 334Acute Lymphoblastic Leukemia researchDrug-Induced Adverse ReactionsChronic Lymphocytic Leukemia Research

L-asparaginase in the treatment of patients with acute lymphoblastic leukemia

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Egler, Rachel A., Ahuja, Sanjay P., Matloub, Yousif·2016·Journal of Pharmacology and Pharmacotherapeutics

Abstract

Acute lymphoblastic leukemia (ALL) is a hematologic malignancy that predominantly occurs in children between 2 and 10 years of age. L-asparaginase is an integral component of treatment for patients with ALL and since its introduction into pediatric treatment protocols in the 1960s, survival rates in children have progressively risen to nearly 90%. Outcomes for adolescent and young adult (AYA) patients, aged 15-39 years and diagnosed with ALL, have historically been less favorable. However, recent reports suggest substantially increased survival in AYA patients treated on pediatric-inspired protocols that include a greater cumulative dose of asparaginase. All currently available asparaginases share the same mechanism of action - the deamination and depletion of serum asparagine levels - yet each displays a markedly different pharmacokinetic profile. Pegylated asparaginase derived from the bacterium Escherichia coli is used as first-line therapy; however, up to 30% of patients develop a treatment-limiting hypersensitivity reaction. Patients who experience a hypersensitivity reaction to an E. coli-derived asparaginase can continue treatment with Erwinia chrysanthemi asparaginase. Erwinia asparaginase is immunologically distinct from E. coli-derived asparaginases and exhibits no cross-reactivity. Studies have shown that with adequate dosing, therapeutic levels of Erwinia asparaginase activity can be achieved, and patients switched to Erwinia asparaginase due to hypersensitivity can obtain outcomes similar to patients who do not experience a hypersensitivity reaction. Therapeutic drug monitoring may be required to ensure that therapeutic levels of asparaginase activity are maintained.

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Crossref · 10.4103/0976-500x.184769

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  • L-asparaginase is effective in treating ALL and is included in standard chemotherapy regimens for the disease.

    “L-asparaginase has been found to be effective in the treatment of ALL and is included in standard chemotherapy regimens for this disease (Table 1)(Egler et al., 2016).”

    From Targeting Metabolism for Cancer Therapy (2017) · cites this paper as Egler et al., 2016

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3 of the 99 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. [1]Gaynon P Schrappe M Cairo M Perkins S Childhood ALL Hematological Malignancies in Children, Adolescents and Young Adults 2012 Hackensack, NJ World Scientific Publishing Company 197 235
  2. [2]Howlader N Noone AM Krapcho M Garshell J Neyman N Altekruse SF National Cancer Institute. Section 28: Childhood cancer by site, incidence, survival, and mortality SEER Cancer Statistics Review, 1975-2011 2014 Bethesda, MD National Cancer Institute
  3. [7]Broome JD Evidence that the L-asparaginase of guinea pig serum is responsible for its antilymphoma effects. I. Properties of the L-asparaginase of guinea pig serum in relation to those of the antilymphoma substance J Exp Med 1963 118 99 120 14015821 PMC2137570
  4. [21]Clarkson B Krakoff I Burchenal J Karnofsky D Golbey R Dowling M Clinical results of treatment with E. coli L-asparaginase in adults with leukemia, lymphoma, and solid tumors Cancer 1970 25 279 305 4905154
  5. [55]Oettgen HF Stephenson PA Schwartz MK Leeper RD Tallai L Tan CC Toxicity of E. coli L-asparaginase in man Cancer 1970 25 253 78 4905153
  6. [71]Schwartz MK Lash ED Oettgen HF Tomato FA L-asparaginase activity in plasma and other biological fluids Cancer 1970 25 244 52 4905152

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Authors
Egler, R. A., Ahuja, S. P., & Matloub, Y.
Affiliations
Rainbow Babies & Children's Hospital (US)
Corresponding author
Egler, Rachel A.
Venue
Journal of Pharmacology and Pharmacotherapeutics
Published
2016-06
Volume
7
Issue
2
Pages
62-71
ISSN
  • 0976-500X (ISSN-L)
  • 0976-5018
OpenAlex
W2471256249
Cited by
334
References
99
Citations by year
2026: 24 · 2025: 28 · 2024: 42 · 2023: 50 · 2022: 36 · 2021: 55 · 2020: 37 · 2019: 26 · 2018: 17 · 2017: 17 · 2016: 1
FWCI
20.16
Type
journal article
Language
en
Open access
Locations
  • Journal of Pharmacology and Pharmacotherapeutics (publishedVersion, cc-by-nc-sa)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Acute Lymphoblastic Leukemia research
  • Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
  • Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
Keywords
L-asparaginase, acute lymphoblastic leukemia, childhood acute lymphoblastic leukemia, adolescent and young adult leukemia, pegylated asparaginase, hypersensitivity, cross-reactivity, pharmacokinetics, therapeutic drug monitoring, survival outcomes

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