Which medications in the drug class Enzymes, Oncology are used in the treatment of Acute Lymphoblastic Leukemia (ALL)?

Updated: Jul 02, 2021
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Enzymes, Oncology

Asparaginase is an enzyme that catalyzes conversion of the amino acid L-asparagine into aspartic acid and ammonia. Pharmacological effect is based on the killing of leukemic cells owing to depletion of plasma asparagine. Leukemic cells with low expression of asparagine synthetase have a reduced ability to synthesize asparagine, and therefore depend on an exogenous source of asparagine for survival.  

Asparaginase Erwinia chrysanthemi recombinant (Rylaze)

Recombinant-derived asparaginase product. Indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) in adult and pediatric patients 1 month or older who have developed hypersensitivity to E coli–derived asparaginase.

Asparaginase Erwinia chrysanthemi (Erwinaze)

Contains an asparagine specific enzyme derived from Erwinia chrysanthemi. Indicated as part of a multiagent chemotherapeutic regimen as a substitute for asparaginase (Elspar), which was discontinued by the manufacturer in August 2012. 

Calaspargase pegol (Asparlasl)

Asparagine specific enzyme derived from Escherichia coli, as a conjugate of L-asparaginase (L-asparagine amidohydrolase) and monomethoxypolyethylene glycol (mPEG) with a succinimidyl carbonate (SC) linker. It is indicated as part of a multiagent chemotherapeutic regimen for ALL in pediatric and young adult patients aged 1 month to 21 years. This product provides a longer interval between doses and an extended shelf-life compared with other asparaginase products.

Pegaspargase (Oncaspar)

Conjugate of monomethoxypolyethylene glycol (mPEG) and E coli–derived L-asparaginase. It is indicated as a component of a multiagent chemotherapeutic regimen for the first-line treatment of ALL. It is also indicated for use in patients with hypersensitivity to native forms of L-asparaginase. Pegylation of the molecule prolongs the duration of action to 2-3 weeks. 

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