The cross-reactivity of anti-asparaginase antibodies against different l-asparaginase preparations

Abstract

Repeated administration of L-asparaginase leads to the development of specific antibodies and hypersensitivity reactions. The aim of the study was to evaluate a possible cross-reaction of anti-asparaginase antibodies, developed against the native E. coli L-asparaginase (Asparaginase Medac), with other preparations of the enzyme. Sixteen patients with acute lymphoblastic leukemia, in whom in the reinduction phase of treatment hypersensitivity against L-asparaginase was observed and/or the presence of anti-asparaginase antibodies was established were recruited for the present study. Ten out of 16 tested sera showed cross-immunoreactivity to PEG-asparaginase, while no reactivity to L-asparaginase derived from Erwinia chrysantemi was observed. Since cross-reacting antibodies were also found in sera of patients with no overt allergic reaction, L: -asparaginase may undergo silent inactivation during the reinduction phase of therapy. This finding is of clinical importance with regard to appropriate dosage and necessitates careful enzyme activity monitoring in all patients undergoing repeated treatment with various L-asparaginase preparations.

Differentiating hypersensitivity versus infusion-related reactions in pediatric patients receiving intravenous asparaginase therapy for acute lymphoblastic leukemia

“…[41,42] These two formulations show considerable cross reactivity, and the incidence of hypersensitivity during PEG-asparaginase therapy is greater in patients with a history of native E. coli asparaginase therapy. [43] Early clinical reports suggested that IV administration of asparaginase was associated with an increased incidence of anaphylactic reactions. [44,45] Within the last 15 years, reported rates of hypersensitivity in clinical trials have varied across studies using different routes of administration and asparaginases (Table 2).…”

A prospective study on drug monitoring of PEGasparaginase and Erwinia asparaginase and asparaginase antibodies in pediatric acute lymphoblastic leukemia

“…9 Clinical allergy is associated with inactivation of asparaginase by antibodies. 10,11 Formation of asparaginase antibodies (AAAs) can also neutralize The online version of this article contains a data supplement.…”

Comparable outcomes between autologous and allogeneic transplant for adult acute myeloid leukemia in first CR

“…Flow cytometry relies heavily on the expertise of the technician who must take into account variability in instruments, fluorochromes, analysis software, and individual antigens. Variations in the treatment schedule, dosing, type NCCN Guidelines Index AML 217 .…”