The anti-asparagines antibodies correlate with L-asparagines activity and may affect clinical outcome of childhood acute lymphoblastic leukemia.
The primary aim of the study was to evaluate the importance of anti-asparaginase antibodies for l-asparaginase activity in children with standard and medium risk acute lymphoblastic leukemia (ALL). Forty-seven children with newly diagnosed ALL were included into the prospective study. Enzyme activity and the presence of anti-asparaginase antibodies (IgG and IgM class) were determined. Anti-asparaginase antibodies were identified in 13/47 (IgM class) and 10/47 (IgG class) patients in the induction and in 19/47 (IgM class) and 20/47 (IgG class) patients in the reinduction phase of treatment. The enzyme activity was lower in patients that were positive for anti-asparaginase antibodies, especially in reinduction phase (median 37 (20 - 180) vs 355 (141 - 499), p = 0.001). An association between anti-asparaginase antibodies and the allergic reaction to the drug was found. Besides, the children who developed anti-asparaginase antibodies in the induction phase of treatment showed lower event-free survival as well as overall survival in comparison with children without antibodies. Since our study was carried out in a small number of patients, this observation is only speculative and needs to be confirmed by a further study on a larger sample size, with multivariable analysis. However, our data suggest that L-asparaginase activity together with anti-asparaginase antibodies measurements may become useful for effective therapy of ALL.
Zalewska-Szewczyk
Beata
B
Oncohematology Unit, Department of Pediatrics, Medical University of Łódz, Łódz, Poland. bszewczyk@alef.umed.lodz.pl
Andrzejewski
Witalij
W
Młynarski
Wojciech
W
Jedrychowska-Dańska
Krystyna
K
Witas
Henryk
H
Bodalski
Jerzy
J
D000293:Adolescent; D000906:Antibodies / Q000737:chemistry; D001216:Asparagine / Q000037:antagonists & inhibitors / Q000737:chemistry* / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000737:chemistry; D007075:Immunoglobulin M / Q000737:chemistry; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000276:immunology* / Q000401:mortality; D011446:Prospective Studies; D016896:Treatment Outcome
D000906:Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D001216:Asparagine