China
Africa
Explore chapters and articles related to this topic
Alternative Tumor-Targeting Strategies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
In the UK, three asparaginase-based products, asparaginase (SpectrilaTM), cristanaspase (ErwinaseTM), and a pegylated product pegaspargase (OncasparTM), are approved and recommended by NICE for use in the treatment of acute lymphoblastic leukemia (in combination with other anticancer agents). In other countries they have also been used to treat, acute myeloid leukemia (AML) and non-Hodgkin’s lymphoma. For example, ElsparTM is approved for use in ALL and in some mast cell tumor protocols. After intravenous, intramuscular, or subcutaneous injection, they all work in the same way by degrading L-asparagine to aspartic acid and ammonia, thus disrupting protein synthesis in tumor cells while healthy cells can synthesize L-asparagine as required.
Acquired Bleeding Disorders Associated with Disease and Medications
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
William A. Rock, Sue D. Walker
Pegaspargase (PEG-L-asparaginase) is associated with a higher-than-usual risk for bleeding problems, especially when given concomitantly with aspirin, NSAIDs, and other drugs that have anticoagulant properties. Adverse reactions of pegaspargase (in the absence of other drugs) include hypofibrinogenemia, prolonged PT and aPTT, decreased AT-III, thrombosis, DIC, and clinical hemorrhage which may be fatal.
PEGylated E. coli asparaginase desensitization: an effective and feasible option for pediatric patients with acute lymphoblastic leukemia who have developed hypersensitivity to pegaspargase in the absence of asparaginase Erwinia chrysanthemi availability
Published in Pediatric Hematology and Oncology, 2019
Anupam Verma, Karin Chen, Cynthia Bender, Nathan Gorney, Whitney Leonard, Phillip Barnette
Recognizing a critical need for an alternative to erwinia asparaginase, our institution developed a standardized rapid desensitization protocol for pegaspargase. The protocol was adapted from drug desensitization protocols published by Castells et al., though never reported to be used for any form of asparaginase. Over the course of five months, ten pediatric ALL and LLy patients were successfully desensitized without recurrence of severe hypersensitivity reactions during administration of the pegaspargase. To our knowledge, this is the first description of successful desensitization of pegaspargase in pediatric ALL and LLy patients. Previous attempts at desensitization have been to l-asparginase, a drug no longer available in the United States.