Asparaginase, chemotherapeutic

Hypersensitivity reactions have occurred with all cancer chemotherapeutic agents. Reactions are most common with the taxanes, platinum compounds, asparaginases, and epipodophyllotoxins.7 Reactions range from mild (e.g., flushing and rashes) to severe (e.g., dyspnea, bronchospasm, urticaria, and hypotension). IgE-mediated type I reactions are the most common. To reduce the risk, patients are routinely pre-medicated... 

B. Indications and use Oncaspar is indicated for patients with ALL who require L-asparaginase in their treatment regimen but have developed hypersensitivity to the native forms of the enzyme. Oncaspar, like native L-asparaginase, is generally used in combination with other chemotherapeutic agents, such as vincristine, methotrexate, cytarabine, daunorubicin, and doxorubicin. 

L-Asparaginase [a SPAR a gi nase] catalyzes the deamination of asparagine to aspartic acid and ammonia. The form of the enzyme used chemotherapeutically is derived from bacteria. 

Verma N, Kumar K, Kaur G et al. (2007) L-asparaginase a promising chemotherapeutic agent. Crit Rev Biotechnol 27 45-62... 

In a combination chemotherapeutic protocol including asparaginases for treatment of patients with relapsed ALL, Abshire et al found that PEG-asparaginase produced a higher reinduction rate than asparaginase. 

The limitation of all cytotoxic chemotherapeutic agents used in cancer (see p. 461) is that they are also toxic to normal cells. In mice tumours that are very sensitive to asparaginase can be cured by as little as one injection of 0 1 unit, the material only becomes toxic at doses of 250,000 units per kilo. Man is, unfortunately, more sensitive to asparaginase than are mice, and the dose that can be given without severe side effects is of the order of 5000 imits per kilo per day. 

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