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Cancer Chemotherapy and Pharmacology
Published in: Cancer Chemotherapy and Pharmacology 6/2014

01-06-2014 | Short Communication

Successful challenges using native E. coli asparaginase after hypersensitivity reactions to PEGylated E. coli asparaginase

Authors: C. A. Fernandez, E. Stewart, J. C. Panetta, M. R. Wilkinson, A. R. Morrison, F. D. Finkelman, J. T. Sandlund, C. H. Pui, S. Jeha, M. V. Relling, P. K. Campbell

Published in: Cancer Chemotherapy and Pharmacology | Issue 6/2014

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Abstract

Purpose

Asparaginase is an essential component of pediatric acute lymphoblastic leukemia (ALL) therapy. However, asparaginase-induced hypersensitivity reactions can compromise its efficacy either by directly influencing the pharmacokinetics of asparaginase or by leading to a discontinuation of asparaginase treatment. Here, we report successful challenges using native Escherichia coli asparaginase after previous hypersensitivity reactions to both PEGylated E. coli asparaginase and Erwinia asparaginase.

Patients and methods

The two patients included in this case report were diagnosed with B-precursor ALL at St. Jude Children’s Research Hospital and were treated with a common regimen. Both patients developed hypersensitivity reactions to PEGylated E. coli asparaginase and Erwinia asparaginase early in treatment, and they were challenged with native E. coli asparaginase. Serum samples were collected for estimating the pharmacokinetic parameters of each patient during native E. coli asparaginase therapy.

Results

Challenges with native E. coli asparaginase were successful, and asparaginase serum concentrations above therapeutic levels were attained in both patients.

Conclusions

These two cases suggest that some patients can be given native E. coli asparaginase after hypersensitivity reactions to PEGylated asparaginase and achieve therapeutic concentrations of the drug in serum.
Appendix
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Metadata
Title
Successful challenges using native E. coli asparaginase after hypersensitivity reactions to PEGylated E. coli asparaginase
Authors
C. A. Fernandez
E. Stewart
J. C. Panetta
M. R. Wilkinson
A. R. Morrison
F. D. Finkelman
J. T. Sandlund
C. H. Pui
S. Jeha
M. V. Relling
P. K. Campbell
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Cancer Chemotherapy and Pharmacology / Issue 6/2014
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-014-2464-2

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