The Medical Letter on Drugs and Therapeutics
FROM
ISSUE
1388
In Brief: Asparaginase Erwinia chrysanthemi (Erwinaze) for ALL
Download PDF:   US English
Med Lett Drugs Ther. 2012 Apr 16;54(1388):32
Disclosures
Objective(s)
 Select a term to see related articles  Acute lymphoblastic leukemia   ALL   aspariginase Erwinia chrysanthemi   Erwinaze   Erwinia   leukemia 

The FDA has approved asparaginase Erwinia chrysanthemi (Erwinaze – EUSA), an asparagine-specific enzyme derived from the gram-negative bacillus Erwinia chrysanthemi, for use in combination with other chemotherapeutic agents for treatment of acute lymphoblastic leukemia (ALL) in patients who have had allergic reactions to Escherichia coli-derived asparaginase (Elspar or pegaspargase [Oncaspar]).

ALL is the most common malignancy of childhood. Multidrug chemotherapy can cure about 80% of children with ALL.1 Initial treatment ("induction") usually includes vincristine, a glucocorticoid, and an asparaginase and/or an anthracycline. Inclusion of an asparaginase in ALL regimens improves outcomes, especially in pediatric patients, but approximately 15-20% of patients treated with E. coli-derived asparaginase will develop hypersensitivity to the drug.

In one study, 42 E. coli asparaginase-allergic children with ALL were switched to twice-weekly Erwinia asparaginase 25,000 IU/m2 to complete 30 weeks of asparaginase treatment; 81% of patients completed ≥26 weeks of therapy. At a median follow-up of 5.4 years, event-free survival in those children was similar to that of children without E. coli asparaginase allergy (86% vs. 81%). Allergy to Erwinia asparaginase developed in 33% of patients.2

© The Medical Letter, Inc. All Rights Reserved.
The Medical Letter, Inc. does not warrant that all the material in this publication is accurate and complete in every respect. The Medical Letter, Inc. and its editors shall not be held responsible for any damage resulting from any error, inaccuracy, or omission.
This article has been freely provided.
arrow to previous article
arrow to next article