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Asparagine concentration in plasma after 2,500 IU/m(2) PEG-asparaginase i.v. in children with acute lymphoblastic leukemia.

AbstractUNLABELLED:
Polyethylene glycol conjugated asparaginase (PEG-ASNase) can be substituted in cases of hypersensitivity to native Escherichia coli asparaginase. We measured asparagine (asn) levels in plasma after a single dose of 2,500 IU/m(2) i.v. PEG-ASNase (Oncaspar) in consolidation treatment of ALL and compared those with data from the previous protocol COALL-05-92. This protocol was similar to COALL-06-97, except that children had been given 45,000 IU/m(2) C-ASNase instead of PEG-ASNase.
PATIENTS AND METHODS:
Between May 2000 and December 2001 seventy-one children (38 boys, 33 girls) with newly diagnosed ALL treated according to the multicenter protocol COALL-06-97 were investigated in this study. Four hundred and seventy-four plasma samples (71 patients) were analysed by ion exchange chromatography after column derivatization with o-phthaldialdehyde. For comparison data (350 plasma samples) from 51 patients treated according to the protocol COALL-05-92 were available. The same method for detection of asn in plasma was used.
RESULTS:
The median asparagine level in plasma after 2,500 IU/m(2) PEG-ASNase i.v. was below the limit of detection for at least 5 weeks in 81 % of the patients. When divided into high risk (HR) and low risk (LR) group, HR patients who had previously received one dose more of C-ASNase showed a markedly shorter depletion than the LR patients compatible with a higher risk of antibody formation and consequent silent inactivation after a higher number of exposures to ASNase. In the previous protocol COALL-05-92 median asn levels in plasma after 45,000 IU/m(2) native C-ASNase i.v. were below the limit of detection for at least 5 weeks in 65 % of the patients.
CONCLUSIONS:
2,500 IU/m(2) PEG-ASNase led to an equally long depletion of asn in plasma as did 45,000 IU/m(2) native C-ASNase i.v. used in COALL-05-92.
AuthorsK A Wenner, J P Vieira Pinheiro, G Escherich, R Wessalowski, N Jorch, J Wolff, M Stehn, A Kohlschütter, J Boos, G E Janka-Schaub
JournalKlinische Padiatrie (Klin Padiatr) 2005 Nov-Dec Vol. 217 Issue 6 Pg. 321-6 ISSN: 0300-8630 [Print] Germany
PMID16307417 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Polyethylene Glycols
  • Asparagine
  • pegaspargase
  • Asparaginase
Topics
  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Asparaginase (administration & dosage)
  • Asparagine (blood)
  • Child
  • Child, Preschool
  • Chromatography, Ion Exchange
  • Dose-Response Relationship, Drug
  • Drug Hypersensitivity (immunology, prevention & control)
  • Female
  • Half-Life
  • Humans
  • Infant
  • Infusions, Intravenous
  • Male
  • Multicenter Studies as Topic
  • Polyethylene Glycols (administration & dosage)
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (blood, drug therapy)
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

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