L-Asparaginase
Indications
L-Asparaginase is an enzyme medicine used to treat acute lymphoblastic leukaemia (ALL), a fast-growing blood cancer, mainly in children and young adults. It is usually given as part of a combination of cancer medicines. It is sometimes used for certain lymphomas.
How It Works
Leukaemia cells in ALL cannot make enough of an amino acid (a protein building block) called asparagine, so they depend on asparagine in the blood. L-Asparaginase breaks down this asparagine. Without it, the cancer cells cannot make proteins and they die, while most normal cells can make their own asparagine.
Dosage and Administration
This is a hospital-only medicine given by injection into a muscle or a vein by a doctor or nurse, in a specialist cancer unit. The dose and schedule are worked out by the specialist based on body size and the treatment protocol. It is given as prescribed. A test dose may be used, and patients are watched closely for allergic reactions after each dose.
Interactions
It can increase the side effects of Vincristine and Methotrexate when given close together, so timing is planned by the specialist. It may affect blood clotting and liver function, which matters with Warfarin, Heparin and other blood thinners, and with corticosteroids such as Prednisolone (higher risk of high blood sugar and clots). Tell the team about all medicines you take.
Contraindications
- Previous serious allergic reaction to asparaginase.
- Previous pancreatitis (inflammation of the pancreas), especially if caused by asparaginase.
- Previous serious blood clots or bleeding with asparaginase.
- Severe liver disease.
Side Effects
Common: allergic reactions (rash, itching, fever), nausea, vomiting, tiredness, raised liver enzymes and high blood sugar. Serious: pancreatitis, blood clots (including in the brain), bleeding, severe allergy and liver damage.
Get urgent medical help for severe tummy pain that spreads to the back, swelling of the face or throat, difficulty breathing, sudden severe headache, weakness on one side, confusion, fits, yellow skin or eyes, or unusual bleeding.
Pregnancy and Lactation
It may harm an unborn baby. Women should avoid pregnancy and use reliable contraception during treatment and for some months after, as advised by the specialist. Breastfeeding is not recommended during treatment.
Precautions and Warnings
- Regular blood tests check blood sugar, clotting, liver and pancreas.
- People with diabetes may need closer sugar control.
- Report any allergic symptoms at once, even mild ones.
Overdose
Overdose is unlikely because it is given in hospital. If it happens, the medical team gives supportive care and monitors closely.
Therapeutic Class
Antineoplastic (anticancer) enzyme.
Storage
Hospital medicine: store as directed on the pack, usually in a refrigerator at 2 to 8°C, do not freeze. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of L-Asparaginase