How it is administered

Pegaspargase is given as an injection, either into a muscle (intramuscularly) or into a vein (intravenously). The medication comes as a clear, colorless solution and is supplied in vials for use in a healthcare setting.

For intramuscular administration, the volume at a single injection site should not exceed 2 mL; if more is needed, multiple injection sites are used. For intravenous administration, pegaspargase is diluted in a solution and infused over 1 to 2 hours. It is usually given no more frequently than every 14 days.

How it works

Pegaspargase is an enzyme that breaks down the amino acid L-asparagine into aspartic acid and ammonia. Many leukemia cells, especially those in acute lymphoblastic leukemia (ALL), cannot make enough asparagine on their own and rely on the supply in the blood. By depleting asparagine, pegaspargase starves these leukemia cells, leading to their death.

Normal cells can usually make their own asparagine and are less affected by this treatment. This selective effect makes pegaspargase a valuable part of combination chemotherapy regimens for ALL. The medication is designed to stay in the body longer than older forms of asparaginase, allowing for less frequent dosing.

Who Should take it

Pegaspargase is used as part of a multi-agent chemotherapy regimen for both children and adults with acute lymphoblastic leukemia (ALL). It is indicated for first-line treatment of ALL, as well as for patients who have developed hypersensitivity (allergic reactions) to other forms of asparaginase.

It can be used in both newly diagnosed patients and those who have relapsed, provided they have not experienced certain serious side effects from asparaginase in the past. Pegaspargase is an important part of standard therapy for ALL and helps improve outcomes when used in combination with other chemotherapy drugs.

Who should not take it

Pegaspargase should not be used by patients who have had serious allergic reactions (including anaphylaxis) to pegaspargase or any of its ingredients. It is also contraindicated in people with a history of serious blood clots (thrombosis), pancreatitis (inflammation of the pancreas), or severe bleeding events related to previous asparaginase therapy.

Patients with severe liver impairment should not receive pegaspargase. If you have had any of these conditions, your healthcare provider will discuss alternative treatments with you.

Commonly used with

Pegaspargase is almost always used in combination with other chemotherapy drugs as part of a multi-agent regimen for ALL. Commonly used medications in these regimens include vincristine, corticosteroids (such as prednisone or dexamethasone), anthracyclines (like doxorubicin or daunorubicin), and other agents depending on the specific protocol.

It is not typically used alone for the treatment of ALL.

Commonly tested with

Pegaspargase has been tested in clinical trials as part of combination chemotherapy regimens for ALL. It is often studied alongside other standard chemotherapy agents such as vincristine, corticosteroids, anthracyclines, and methotrexate. These studies help determine the best combinations and dosing schedules to maximize effectiveness and minimize side effects.