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Catalyzing improvements in ALL therapy with asparaginase
Bernard L Marini1, Anthony J Perissinotti1, Dale L Bixby2
1Department of Pharmacy Services and Clinical Sciences, University of Michigan Health System and College of Pharmacy, 1111 E. Catherine St., Ann Arbor, MI 48109, USA.
Blood Reviews
|July 13, 2017
Summary
Therapeutic drug monitoring of asparaginase, a key treatment for acute lymphoblastic leukemia (ALL), can optimize asparagine depletion and improve patient outcomes. This approach, though underutilized, is crucial for enhancing ALL therapy effectiveness.
Area of Science:
- Oncology
- Pharmacology
Background:
- Asparaginase is a critical component in treating acute lymphoblastic leukemia (ALL), particularly in adolescent and young adult (AYA) patients.
- Asparagine depletion correlates with better outcomes in ALL patients, driving efforts to optimize this process across all age groups.
Purpose of the Study:
- To review data on asparaginase activity level monitoring and its impact on patient outcomes.
- To present an evidence-based algorithm for asparaginase activity level monitoring.
- To discuss strategies for managing asparaginase toxicities and emerging formulations.
Main Methods:
- Review of existing data on asparaginase activity monitoring and clinical outcomes.
- Development of an evidence-based algorithm for therapeutic drug monitoring of asparaginase.
- Discussion of toxicity management and novel drug formulations.
Main Results:
- Asparaginase therapy is vital for ALL treatment, with asparagine depletion linked to improved outcomes.
- Therapeutic drug monitoring of asparaginase shows promise for ensuring adequate asparagine depletion but is currently underutilized.
- An evidence-based algorithm and management strategies for toxicities are presented.
Conclusions:
- Optimizing asparagine depletion through therapeutic drug monitoring of asparaginase is essential for improving ALL patient outcomes.
- The presented algorithm and toxicity management strategies aim to enhance the clinical utility of asparaginase therapy.
- Future directions include exploring novel asparaginase formulations to further improve treatment efficacy and safety.
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