title: Monitoring of anti-L-asparaginase antibody and L-asparaginase activity levels in a pediatric patient with acute lymphoblastic leukemia and hypersensitivity to native Escherichia coli L-asparaginase during desensitization courses.
abstract: A patient with acute lymphoblastic leukemia who was hypersensitive to native Escherichia coli L-asparaginase (L-asp) underwent readministration of the L-asp without serious adverse effects for 11 doses using a desensitization protocol every time. Monitoring of anti-L-asp antibody and L-asp activity levels revealed that the serum L-asp activity was below the effective levels during the administration of first 6 to 7 doses because of extremely high levels of anti-L-asp IgG. Sustained L-asp activity was attained since the eighth dose was administered, when the antibody levels were <5 U/mL. L-asp activity levels in patients with L-asp hypersensitivity should be monitored during the desensitization courses to ensure a sufficient L-asp activity.
authors.affiliation: Department of Pediatrics, Jichi Medical University School of Medicine, Yakushiji, Shimotsuke, Tochigi, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Kawahara
authors.forename: Akira
authors.initials: A
authors.lastname: Morimoto
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hayase
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kashii
authors.forename: Tokiko
authors.initials: T
authors.lastname: Fukuda
authors.forename: Mariko Y
authors.initials: MY
authors.lastname: Momoi
mesh_terms: D000970:Antineoplastic Agents / Q000276:immunology*; D001215:Asparaginase / Q000276:immunology*; D001216:Asparagine / Q000378:metabolism; D002675:Child, Preschool; D003888:Desensitization, Immunologic / Q000379:methods*; D004342:Drug Hypersensitivity / Q000097:blood / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D004926:Escherichia coli / Q000276:immunology; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D001216:Asparagine; D001215:Asparaginase