A Clinical Study of the Side Effects of L-Asparaginase

Woo, Chann Wook; Lee, Jung Hwa; Lee, Kwang Chul; Kim, Soon Kyum

Abstract

PURPOSE: We evaluated the frequency and clinical characteristics of the side effects of L-asparaginase during treatment of childrens with acute lymphoblastic leukemia (ALL) & Non-Hodgkin lymphoma (NHL).
METHODS
Medical records of children who were treated as 37 ALL and 3 NHL in Korea University Medical Center from January 1995 to June 1998 were reviewed.
RESULTS
1) The 40 patients (21 males and 19 females) had a mean age of 6.2+/-3.3 (range, 0.4~12.8). 2) Nine (7 ALL, 2 NHL) of these 40 patients (median: 5.0 years, range: 3.8~11.5 years) had side reactions (5 hypersensitivity, 2 hyperglycemia, 1 pancreatitis, 1 CNS abnormality) to Escherichia coli L-asparaginase. 3) The hypersensitivity reactions to E. coli asparaginase were the most common side effects. Erwinia asparaginase administered to those patients without side reactions. 4) The range of doses of E. coli asparaginase received prior to experiencing any hypersensitivity was 10 to 22 times. 5) Other reactions (hyperglycemia, pancreatitis and CNS abnormality) were developed at early diseases state and completely recovered.
CONCLUSION
We found Erwinia asparaginase to be an acceptable substitute for E. coli asparagianse for childrens who had hypersensitivity reactions. In our experience, hypersensitivity reactions are do not detected in inducton therapeutic period. But, We recommend that you should carefully observe your patients during the early induction period.