Pegaspargase: A Review in Acute Lymphoblastic Leukaemia
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Disclosure: The preparation of this review was not supported by any external funding. The video abstract was developed after publication of the original article and funded by the sponsorship of Servier Affaires Medicales, Suresnes, France
Conflicts of interest: Young-A Heo, Yahiya Syed and Susan Keam are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.
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Pegaspargase (Oncaspar®), a pegylated form of native Escherichia coli-derived L-asparaginase (hereafter referred as E. coli L-asparaginase), is indicated in the USA and EU for the treatment of acute lymphoblastic leukaemia (ALL) as a component of multi-agent chemotherapy in paediatric and adult patients. Relative to E. coli L-asparaginase, pegaspargase has a prolonged circulation time, thereby offering less frequent administration. Moreover, pegylation of E. coli L-asparaginase may diminish the immunogenicity of the enzyme. Based on extensive evidence, intramuscular (IM) or intravenous (IV) administration of pegaspargase as a component of a multi-agent chemotherapy is an effective first-line treatment for paediatric and adult patients with ALL, as well as for the treatment of paediatric and adult patients with ALL and hypersensitivity to E. coli L-asparaginase. Pegaspargase had a manageable tolerability profile in paediatric and adult patients with newly diagnosed ALL, with the most commonly occurring adverse events being generally consistent to that seen with E. coli L-asparaginase. Pegaspargase treatment in patients with relapsed ALL and hypersensitivity to E. coli L-asparaginase had a similar tolerability profile to that observed in patients with newly diagnosed ALL. Given the potentially reduced immunogenicity and more convenient dosage regimen over E. coli L-asparaginase, pegaspargase remains an important and effective treatment option for paediatric and adult patients with ALL, including those with hypersensitivity to E. coli L-asparaginase.
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