title: Development of anti-asparaginase antibodies in childhood acute lymphoblastic leukemia.
abstract: L-asparaginase is a basic agent of antileukemic therapy, but allergic reactions against the drug and the development of anti-asparaginase antibodies are significant side-effects. The aim of our study was to estimate the presence of anti-asparaginase antibodies and to correlate the results with clinically apparent allergic reactions and with L-asparaginase activity during the treatment. We examined 13 children with newly diagnosed acute lymphoblastic leukemia (ALL), treated according to the Polish Pediatric Leukemia/Lymphoma Group protocol, based on ALL-BFM 95. Enzyme activity was estimated in serum samples, collected before each L-asparaginase administration, using the photometrical method. Anti-asparaginase antibody concentration was measured by enzyme-linked immunosorbent assay (ELISA) at the two time points: at the last day of L-asparaginase treatment in the induction and the reinduction phase. The mean L-asparaginase activity was 273 IU/L in the induction phase; no anti-asparaginase antibodies in this phase of treatment were found. The mean L-asparaginase activity was 425 IU/L in the reinduction phase of treatment; in five children anti-asparaginase antibodies were detected. In four of these five children low L-asparaginase activity and/or allergic reactions against L-asparaginase were noted. Our observations suggest a correlation between the presence of anti-asparaginase antibodies and L-asparaginase activity in childhood ALL.
authors.affiliation: Clinic of Pediatrics, Institute of Pediatrics, Medical University of Łódź, Poland. bszewczyk@smrw.lodz.pl
authors.forename: Beata
authors.initials: B
authors.lastname: Zalewska-Szewczyk
authors.forename: Witalij
authors.initials: W
authors.lastname: Andrzejewski
authors.forename: Jerzy
authors.initials: J
authors.lastname: Bodalski
mesh_terms: D000293:Adolescent; D000917:Antibody Formation; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000276:immunology* / Q000627:therapeutic use; D001215:Asparaginase / Q000009:adverse effects* / Q000276:immunology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004342:Drug Hypersensitivity / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000276:immunology*
chemical_list: D000970:Antineoplastic Agents; D001215:Asparaginase