title: Asparaginase Erwinia chrysanthemi as a component of a multi-agent chemotherapeutic regimen for the treatment of patients with acute lymphoblastic leukemia who have developed hypersensitivity to E. coli-derived asparaginase.
abstract: Asparaginase has been a mainstay of therapy in the treatment of acute lymphoblastic leukemia since the 1970s. There are two major preparations available and FDA approved in the United States today, one derived from Escherichia coli and the other from Erwinia chrysanthemi. Erwinia asparaginase is antigenically distinct from and has a considerably shorter biological half-life than E coli asparaginase. Erwinia asparaginase has been used in cases of hypersensitivity to E. coli-derived asparaginases, which has been reported in up to 30% of patients. While PEG asparaginase is increasingly used in front-line therapy for ALL, hypersensitivity still occurs with this preparation, and a change to a non-cross-reactive preparation may be necessary.
authors.affiliation: a Pediatric Hematology/Oncology , Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx , NY , USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Figueiredo
authors.affiliation: a Pediatric Hematology/Oncology , Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx , NY , USA.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Cole
authors.affiliation: b Pediatic Hematology/Oncology , Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School , New Brunswick , NJ , USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Drachtman
mesh_terms: D000818:Animals; D001215:Asparaginase / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D016974:Dickeya chrysanthemi / Q000201:enzymology*; D004342:Drug Hypersensitivity / Q000209:etiology; D057487:Enzyme Therapy / Q000379:methods; D004926:Escherichia coli / Q000201:enzymology*; D006801:Humans; D010195:Pancreatitis / Q000139:chemically induced; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D013927:Thrombosis / Q000139:chemically induced
chemical_list: D001215:Asparaginase
keywords: Asparaginase; hypersensitivity; leukemia; pancreatitis; thrombosis