L‐asparaginase treatment in acute lymphoblastic leukemia

Cancer - Tập 117 Số 2 - Trang 238-249 - 2011
Rob Pieters1,2,3, Stephen P. Hunger4, Joachim Boos5, Carmelo Rizzari6, Lewis B. Silverman7, André Baruchel8, Nicola Goekbuget9, Martin Schrappe10, Ching‐Hon Pui1,11,3,12
1Ching-Hon Pui, Department of Oncology, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105===
2Erasmus MC-Sophia Children’s Hospital, Rotterdam, Netherlands
3Rob Pieters, Erasmus MC-Sophia Children's Hospital, Dr Molewaterplein 60, Rotterdam, Netherlands===
4The Department of Pediatrics, University of Colorado, Denver School of Medicine and the Children's Hospital, Aurora, Colorado
5University Children's Hospital Münster, Department of Pediatric Hematology and Oncology, Münster, Germany
6Department of Pediatrics, University of Milano-Bicocca, Hospital S Gerardo, Monza, Italy
7Department of Pediatric Oncology, Dana-Farber Cancer Institute/Children's Hospital Boston, Boston, Massachusetts
8Hospital Saint-Louis and Robert Debré AP-HP, University Paris Diderot, Paris, France
9J.W. Goethe University Hospital, Department of Internal Medicine II, Frankfurt, Germany
10Department of General Pediatrics, University Medical Center Schleswig-Holstein, Kiel, Germany
11Department of Oncology, St Jude Children's Research Hospital and the University of Tennessee Health Science Center, Memphis, Tennessee
12Telephone: 901-595-3300

Tóm tắt

AbstractAsparaginases are a cornerstone of treatment protocols for acute lymphoblastic leukemia (ALL) and are used for remission induction and intensification treatment in all pediatric regimens and in the majority of adult treatment protocols. Extensive clinical data have shown that intensive asparaginase treatment improves clinical outcomes in childhood ALL. Three asparaginase preparations are available: the native asparaginase derived from Escherichia coli (E. coli asparaginase), a pegylated form of this enzyme (PEG‐asparaginase), and a product isolated from Erwinia chrysanthemi, ie, Erwinia asparaginase. Clinical hypersensitivity reactions and silent inactivation due to antibodies against E. coli asparaginase, lead to inactivation of E. coli asparaginase in up to 60% of cases. Current treatment protocols include E. coli asparaginase or PEG‐asparaginase for first‐line treatment of ALL. Typically, patients exhibiting sensitivity to one formulation of asparaginase are switched to another to ensure they receive the most efficacious treatment regimen possible. Erwinia asparaginase is used as a second‐ or third‐line treatment in European and US protocols. Despite the universal inclusion of asparaginase in such treatment protocols, debate on the optimal formulation and dosage of these agents continues. This article provides an overview of available evidence for optimal use of Erwinia asparaginase in the treatment of ALL. Cancer 2011. © 2010 American Cancer Society.

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Cancer

Tập 117 Số 2

238-249

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