Asparaginase activities during intensified treatment with pegylated E. coli asparaginase in adults with newly-diagnosed acute lymphoblastic leukemia

• Published in: Leukemia & lymphoma 2020-01, Vol.61 (1), p.138-145
• Main Authors: Lanvers-Kaminsky, Claudia, Niemann, Andreas, Eveslage, Maria, Beck, Joachim, Köhnke, Thomas, Martin, Sonja, de Wit, Maike, Spriewald, Bernd, Hauspurg, Holger, Hoelzer, Dieter, Boos, Joachim, Gökbuget, Nicola
• Format: Article
• Language: English
• Subjects: Adult; Adult ALL; Antineoplastic Agents - therapeutic use; Asparaginase - therapeutic use; asparaginase activity; drug monitoring; Escherichia coli; Humans; pegylated E. coli asparaginase; Polyethylene Glycols - therapeutic use; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/10428194.2019.1658099

The GMALL07/2003 protocol introduced pegylated E. coli asparaginase (PEG-ASNase) frontline for adults with acute lymphoblastic leukemia (ALL). PEG-ASNase (500 U/m 2 , 1000 U/m 2 , or 2000 U/m 2 ) was given once in induction and as part of three HD-MTX/PEG-ASNase cycles with two PEG-ASNase doses every other week in consolidation. PEG-ASNase activities were monitored in 1363 serum samples from 304 ALL patients. The overall rate of silent inactivation was low (5%) and did not differ between induction and consolidation. The successful targeting of PEG-ASNase activities ≥100 U/L depended on protocol and dose. Overall PEG-ASNase activities were higher during consolidation compared to induction. To target PEG-ASNase activities ≥100 U/L for 14 day with a single dose in induction, 2000 U/m 2 was more preferable than 1000 U/m 2 or 500 U/m 2 . During consolidation with two administrations every other week, 1000 U/m 2 and 2000 U/m 2 were similarly effective in sustaining PEG-ASNase ≥100 U/L activities over 14 days.