title: Asparaginase Erwinia chrysanthemi (Erwinaze®): a guide to its use in acute lymphoblastic leukemia in the USA.
abstract: Asparaginase Erwinia chrysanthemi (Erwinaze®) is approved in the USA for use in patients with acute lymphoblastic leukemia (ALL) who have developed hypersensitivity to Escherichia coli-derived asparaginase. The approved regimen of intramuscular Erwinaze® was associated with sustained, clinically meaningful asparaginase activity in patients with ALL who had to discontinue treatment with pegaspargase (a pegylated formulation of E. coli asparaginase) because of hypersensitivity. Another study revealed that development of E. coli-derived asparaginase allergy and a switch to Erwinaze® maintained event-free survival in pediatric patients with newly diagnosed ALL. In a multicenter, compassionate-use trial, Erwinaze® was generally well tolerated, with the most commonly occurring adverse events including hypersensitivity, pancreatitis, fever, hyperglycemia, and increased transaminase levels. Subclinical hypersensitivity may result in the inactivation of asparaginase and affect treatment outcome; monitoring of serum asparaginase levels may be used to identify subclinical hypersensitivity.
authors.affiliation: Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, 0754 Auckland, New Zealand. demail@springer.com
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Keating
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D001216:Asparagine / Q000097:blood / Q000378:metabolism; D001426:Bacterial Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D004342:Drug Hypersensitivity / Q000209:etiology; D016903:Drug Monitoring; D015507:Drugs, Investigational / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D057487:Enzyme Therapy / Q000009:adverse effects; D004885:Erwinia / Q000201:enzymology*; D029968:Escherichia coli Proteins / Q000009:adverse effects; D006801:Humans; D007273:Injections, Intramuscular; D011092:Polyethylene Glycols / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D014481:United States
chemical_list: D000970:Antineoplastic Agents; D001426:Bacterial Proteins; D015507:Drugs, Investigational; D029968:Escherichia coli Proteins; D011092:Polyethylene Glycols; D001216:Asparagine; C042705:pegaspargase; D001215:Asparaginase