Asparaginase: an old drug with new questions
Hematol., Transfus. Cell Ther. (Impr.)
;
42(3): 275-282, July-Sept. 2020. tab, ilus
Artículo
en Inglés
| LILACS
| ID: biblio-1134044
ABSTRACT
ABSTRACT The long-term outcome of acute lymphoblastic leukemia has improved dramatically due to the development of more effective treatment strategies. L-asparaginase (ASNase) is one of the main drugs used and causes death of leukemic cells by systematically depleting the non-essential amino acid asparagine. Three main types of ASNase have been used so far native ASNase derived from Escherichia coli, an enzyme isolated from Erwinia chrysanthemi and a pegylated form of the native E. coli ASNase, the ASNase PEG. Hypersensitivity reactions are the main complication related to this drug. Although clinical allergies may be important, a major concern is that antibodies produced in response to ASNase may cause rapid inactivation of ASNase, leading to a worse prognosis. This reaction is commonly referred to as "silent hypersensitivity" or "silent inactivation". We are able to analyze hypersensitivity and inactivation processes by the measurement of the ASNase activity. The ability to individualize the ASNase therapy in patients, adjusting the dose or switching patients with silent inactivation to an alternate ASNase preparation may help improve outcomes in those patients. This review article aims to describe the pathophysiology of the inactivation process, how to diagnose it and finally how to manage it.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Asparaginasa
/
Leucemia-Linfoma Linfoblástico de Células Precursoras
/
Hipersensibilidad
Límite:
Humanos
Idioma:
Inglés
Revista:
Hematol., Transfus. Cell Ther. (Impr.)
Asunto de la revista:
Hematologia
/
TransfusÆo de Sangue
Año:
2020
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Hospital Santa Marcelina/BR
/
Hospital de Clínicas de Porto Alegre/BR
/
Universidade Federal do Rio Grande do Sul/BR
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