Anti-Erwinia asparaginase antibodies during treatment of childhood acute lymphoblastic leukemia and their relationship to outcome: a case-control study.
OBJECTIVE
A case-control study was performed to determine whether patients who had been treated with Erwinia asparaginase as part of their treatment for childhood acute lymphoblastic leukemia (ALL) and who showed relapsed of their disease more often developed anti-asparaginase antibodies than patients who remained in remission.


METHODS
A group of 13 patients who showed relapsed of their disease (median follow-up 35 months) were randomly matched with control patients of the same risk group (two control patients to each case), who had received therapy of the same intensity during the same period (median follow-up 70 months). Anti- Erwinia asparaginase antibodies were measured (ELISA method) during maintenance therapy after asparaginase treatment (30,000 IU/m(2) daily for 10 days in all patients plus twice weekly for 2 weeks in intermediate-risk and high-risk ALL patients).


RESULTS
The overall incidence of anti- Erwinia asparaginase antibodies was 8% (3 of 39 patients). There was no statistically significant difference in the incidence of antibody formation between patients who had suffered relapse (1 of 13) and those who had not (2 of 26). In two of the three patients who developed antibodies, the antibodies disappeared after some time, whereas one patient had measurable antibody levels for more than a year after asparaginase therapy.


CONCLUSIONS
In this study, the development of anti-Erwinia asparaginase antibodies was rare and was unrelated to the risk of relapse.
Klug Albertsen
Birgitte
B
Department of Pharmacology, The Bartholin Building, University of Aarhus, 8000 Aarhus C, Denmark. bka@farm.au.dk
Schmiegelow
Kjeld
K
Schrøder
Henrik
H
Carlsen
Niels T
NT
Rosthøj
Steen
S
Avramis
Vassilios I
VI
Jakobsen
Preben
P
D000293:Adolescent; D000907:Antibodies, Bacterial / Q000096:biosynthesis* / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001215:Asparaginase / Q000008:administration & dosage / Q000276:immunology*; D001426:Bacterial Proteins / Q000008:administration & dosage / Q000276:immunology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D004885:Erwinia / Q000201:enzymology / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D011897:Random Allocation; D012306:Risk; D016896:Treatment Outcome
D000907:Antibodies, Bacterial; D001426:Bacterial Proteins; D001215:Asparaginase