Toxicity of L-asparaginase drugs in acute lymphoblastic leukemia treatment
https://doi.org/10.17650/1818-8346-2023-18-3-134-139
Abstract
Currently no therapy of acute lymphoblastic leukemia is conceivable without L-asparaginase drugs, with its antileukemic effect by extracellular asparagine depletion, thus preventing its admission to leukemic cell. Besides high antitumor effect, L-asparaginase drugs have side and toxic effects, such as hypersensitivity reactions, thrombosis, pancreatitis / pancreatic necrosis, and hepatotoxicity. For L-asparaginase safety profile improvement a technology of pegylation was lay down and PEG-aspargase drug produced. This drug has less toxic effects and recommended as first-line therapy of acute lymphoblastic leukemia. Drug monitoring for assessment the effectiveness and toxicity of L-asparaginase is optimal. Such therapy individualization helps for L-asparaginase dose finding and decrease frequency and severity of side effects.
Supporting agencies: The work was performed without external funding
About the Author
T. T. Valiev
Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
Timur Teymurazovich Valiev
115478
23 Kashirskoe Shosse
119991
Build. 2, 8 Trubetskaya St.
Moscow
References
1. Batool T., Makky E.A., Jalal M., Yusoff M.M. A comprehensive review on L-asparaginase and its applications. Appl Biochem Biotechnol 2016;178(5):900–23. DOI: 10.1007/s12010-015-1917-3
2. Fonseca M.H.G., Fiúza T.D.S., Morais S.B. et al. Circumventing the side effects of L-asparaginase. Biomed Pharmacother 2021;139:111616. DOI: 10.1016/j.biopha.2021.111616
3. L-asparaginase. Russian Register of Medicinal Products. Available at: https://www.rlsnet.ru/drugs/l-asparaginaza-763. (In Russ.).
4. Lubkowski J., Wlodawer A. Structural and biochemical properties of L-asparaginase. FEBS J 2021;288(14):4183–209. DOI: 10.1111/febs.16042
5. Goroshkova M.Yu. Intensive use of COLI-asparaginase in the MV 2002 protocol: results of a randomized study in patients with acute lymphoblastic leukemia of the standard risk group. Dis. … candidate of medical sciences. Moscow, 2008. (In Russ.).
6. Lopez-Santillan M., Iparraguirre L., Martin-Guerrero I. et al. Review of pharmacogenetics studies of L-asparaginase hypersensitivity in acute lymphoblastic leukemia points to variants in the GRIA1 gene. Drug Metab Pers Ther 2017;32(1):1–9. DOI: 10.1515/dmpt-2016-0033
7. Dinkina Yu.V., Belogurova M.B. Possibilities of personification of therapy in pediatric oncology: literature review. Rossiyskiy zhurnal detskoy gematologii i oncologii = Russian Journal of Pediatric Hematology аnd Oncology 2021;8(4):71–80. (In Russ.). DOI: 10.21682/2311-1267-2021-8-4-71-80
8. Hijiya N., van der Sluis I.M. Asparaginase-associated toxicity in children with acute lymphoblastic leukemia. Leuk Lymphoma 2016;57(4):748–57. DOI: 10.3109/10428194.2015.1101098
9. Pokrovskiy V.S., Treshchalina E.M. Enzymes in oncohematology: relevant direction of experimental studies and prospects for clinical use. Klinicheskaya onkogematologiya. Fundamentalnye issledovaniya i klinicheskaya praktika = Clinical Oncohematology. Basic Research and Clinical Practice 2014;7(1):28–38. (In Russ.).
10. Schmidt M.P., Ivanov A.V., Coriu D., Miron I.C. L-Asparaginase toxicity in the treatment of children and adolescents with acute lymphoblastic leukemia. J Clin Med 2021;10(19):4419. DOI: 10.3390/jcm10194419
11. Meghavarnam A.K., Salah M., Sreepriya M., Janakiraman S. Growth inhibitory and proapoptotic effects of l-asparaginase from Fusarium culmorum ASP-87 on human leukemia cells (Jurkat). Fundam Clin Pharmacol 2017;31(3):292–300. DOI: 10.1111/fcp.12257
12. Abd El-Baky H.H., El-Baroty G.S. Spirulina maxima L-asparaginase: Immobilization, Antiviral and Antiproliferation Activities. Recent Pat Biotechnol 2020;14(2):154–63. DOI: 10.2174/1872208313666191114151344
13. Avramis V.I., Sencer S., Periclou A.P. et al. A randomized comparison of native Escherichia coli asparaginase and polyethylene glycol conjugated asparaginase for treatment of children with newly diagnosed standard-risk acute lymphoblastic leukemia: a Children’s Cancer Group study. Blood 2002;99(6):1986–94. DOI: 10.1182/blood.v99.6.1986
14. Stensig Lynggaard L., Rank C.U., Als-Nielsen B. et al. PEGasparaginase treatment regimens for acute lymphoblastic leukaemia in children: a network meta-analysis. Cochrane Database Syst Rev 2023;5(5):CD014570. DOI: 10.1002/14651858.CD014570.pub2
15. Asselin B., Rizzari C. Asparaginase pharmacokinetics and implications of therapeutic drug monitoring. Leuk Lymphoma 2015;56(8):2273–80. DOI: 10.3109/10428194.2014.1003056
16. Chiu M., Taurino G., Bianchi M.G. et al. Asparagine synthetase in cancer: beyond acute lymphoblastic leukemia. Front Oncol 2020;9:1480. DOI: 10.3389/fonc.2019.01480
17. Cooper S.L., Young D.J., Bowen C.J. et al. Universal premedication and therapeutic drug monitoring for asparaginase-based therapy prevents infusion-associated acute adverse events and drug substitutions. Pediatr Blood Cancer 2019;66(8):e27797. DOI: 10.1002/pbc.27797
18. Marini B.L., Brown J., Benitez L. et al. A single-center multidisciplinary approach to managing the global Erwinia asparaginase shortage. Leuk Lymph 2019;60(16):2854–68. DOI: 10.1080/10428194.2019.1608530
Review
For citations:
Valiev T.T. Toxicity of L-asparaginase drugs in acute lymphoblastic leukemia treatment. Oncohematology. 2023;18(3):134-139. (In Russ.) https://doi.org/10.17650/1818-8346-2023-18-3-134-139
Views:
4635
Email this article 