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How it is administered
Asparaginase erwinia chrysanthemi (recombinant)-rywn is administered as an intramuscular injection. It is supplied as a clear to slightly yellow solution in single-use vials. The recommended dosage is based on body surface area and is typically given either every 48 hours or on a Monday/Wednesday/Friday schedule. The injection is given into the muscle, and if the volume exceeds 2 mL, it should be divided into multiple injection sites.
It is important that this medication is administered by a healthcare professional in a clinical setting, where emergency equipment is available in case of severe allergic reactions.
How it works
Asparaginase works by breaking down the amino acid L-asparagine into aspartic acid and ammonia. Many leukemia cells, especially those in acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL), cannot make enough asparagine on their own and rely on the supply in the blood. By depleting asparagine, asparaginase essentially starves these cancer cells, leading to their death.
Normal cells can usually produce their own asparagine and are less affected by this treatment. This targeted action makes asparaginase an important component of multi-agent chemotherapy regimens for certain blood cancers. The medication is particularly useful for patients who have developed hypersensitivity to E. coli-derived asparaginase products.
Common side effects
Common side effects of asparaginase include:
- Abnormal liver tests (elevated liver enzymes or bilirubin)
- Nausea and vomiting
- Musculoskeletal pain (joint or muscle pain)
- Infections
- Fatigue
- Headache
- Fever (pyrexia)
- Bleeding or bruising
- Mouth sores (stomatitis)
- Abdominal pain
- Decreased appetite
- Allergic reactions (rash, swelling, itching)
- High blood sugar (hyperglycemia)
- Diarrhea
- Pancreatitis (inflammation of the pancreas)
- Low potassium (hypokalemia)
Serious side effects can include severe allergic reactions, pancreatitis, blood clots, severe bleeding, and liver problems. Always report any unusual symptoms to your healthcare provider.
Who Should take it
Asparaginase is indicated for adult and pediatric patients (1 month or older) with acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma (LBL) who have developed hypersensitivity to E. coli-derived asparaginase. It is used as part of a multi-agent chemotherapy regimen.
This medication is especially important for patients who cannot tolerate standard asparaginase products due to allergic reactions. It helps ensure that these patients can still receive effective asparaginase therapy as part of their cancer treatment.
Who should not take it
You should not take asparaginase if you have had serious hypersensitivity reactions (including anaphylaxis) to asparaginase erwinia chrysanthemi or similar products. It is also contraindicated in patients with a history of serious pancreatitis, serious blood clots (thrombosis), or serious bleeding events during previous asparaginase therapy.
Additionally, patients with severe liver impairment should not receive this medication. If you have any of these conditions or a history of severe reactions to asparaginase, your doctor will discuss alternative treatment options.
Commonly used with
Asparaginase is used as part of a multi-agent chemotherapy regimen for blood cancers such as ALL and LBL. It is commonly combined with other chemotherapy drugs, including vincristine, corticosteroids (like prednisone or dexamethasone), anthracyclines (like doxorubicin), and other agents depending on the specific treatment protocol.
The combination helps target cancer cells through different mechanisms, improving the chances of remission and cure.
Commonly tested with
Asparaginase is often tested in combination with other standard chemotherapy agents for ALL and LBL. Clinical studies have evaluated its use alongside drugs such as vincristine, corticosteroids, methotrexate, cytarabine, and anthracyclines. These combinations are designed to maximize cancer cell kill while managing side effects and minimizing the risk of resistance.
Patients may also undergo regular blood tests to monitor liver function, blood cell counts, and asparaginase activity during treatment.
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