Comparison of anaphylactic reactions to asparaginase derived from Escherichia coli and from Erwinia cultures.
A retrospective study was undertaken comparing the frequency and severity of anaphylactic reactions to E. coli-derived and Erwinia-derived asparaginase given intravenously on a weekly dosage schedule. Both drugs were found to produce life-threatening hypersensivity reactions with the chance of reaction per dose administered being almost identical--8% for each dose administered. Eleven of 31 patients (35%) experienced anaphylactic reactions, 9/27 (33%) with E. coli and 3/10 (30%) with Erwinia asparaginase, with one patient suffering anaphylaxis to both preparations. A marked increase in the percentage of patients having reactions occurred after the fourth dose of either preparation, with the incidence per dose increasing from 3.3% with the first dose to 32% on the fifth and subsequent doses. Rationale for an antibody-mediated allergic reaction is presented to explain the data.
D000293:Adolescent; D000707:Anaphylaxis / Q000139:chemically induced*; D000937:Antigen-Antibody Reactions; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D004334:Drug Administration Schedule; D004885:Erwinia / Q000201:enzymology; D004926:Escherichia coli / Q000201:enzymology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007075:Immunoglobulin M / Q000378:metabolism; D007945:Leukemia, Lymphoid / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies
D007074:Immunoglobulin G; D007075:Immunoglobulin M; D001215:Asparaginase