II. Indications

  1. Acute Lymphoblastic Leukemia (FDA approved in adults and children)

III. Mechanism

  1. Asparaginase is an enzyme extracted from Escherichia coliBacteria
    1. A similar enzyme is extracted from the BacteriaErwinia carotovora, for use in asparaginase Hypersensitivity
    2. Another Asparaginase source is the BacteriaErwinia Chrysanthemi
  2. Asparaginase hydrolyzes L-Asparagine to L-Aspartic Acid and ammonia
    1. Results in deficiency of the conditional Essential Amino Acid, Asparagine, and inhibiting Protein synthesis
    2. Susceptible cells (esp. leukemic cells) are arrested in G1 phase of the Cell Cycle, and undergo apoptosis
      1. Leukemic cells lack the enzyme , preventing Asparaginase replacement
      2. Normal cells, in contrast, contain adequate Asparagine synthase to replenish Asparagine

IV. Dosing

  1. See other references for disease specific dosing protocols

V. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception

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