Is asparaginase a critical component in the treatment of acute lymphoblastic leukemia?

The outcome of pediatric acute lymphoblastic leukemia (ALL) has improved dramatically over the last 40 years through a systematic approach of well-designed large trials including use of asparaginase. Although asparaginase has been incorporated with other drugs in adult ALL protocols, it has been ass...

Full description

Saved in:
Bibliographic Details
Published in:Best practice & research. Clinical haematology 2008-12, Vol.21 (4), p.647-658
Main Author: Douer, Dan, MD
Format: Article
Language:English
Subjects:
Adult
adult ALL
Age Factors
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
asparaginase
Asparaginase - pharmacology
Asparaginase - therapeutic use
Asparaginase - toxicity
Child
Hematology, Oncology and Palliative Medicine
Humans
Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The outcome of pediatric acute lymphoblastic leukemia (ALL) has improved dramatically over the last 40 years through a systematic approach of well-designed large trials including use of asparaginase. Although asparaginase has been incorporated with other drugs in adult ALL protocols, it has been associated with more toxicities in older patients resulting in caution in the inclusion of asparaginase-containing regimens for adults. Consequently, to date, no randomized trials with asparaginase have been performed in adults. Furthermore, adult regimens that do not include asparaginase have shown comparable outcomes to regimens with asparaginase, which makes the necessity of asparaginase in adult regimens unclear. There are several other factors which influence the role of asparaginase use in adults, including the level and sustainability of asparagine depletion, schedule, dosing, and form of asparaginase and the consequent toxicities and immunogenicity reactions.
ISSN:1521-6926
1532-1924
DOI:10.1016/j.beha.2008.08.004