Related Experiment Video

Updated: Oct 19, 2025

In Ovo Xenografting of Patient-Derived Acute Lymphoblastic Leukemia (ALL) Cells (PDX-ALL)
06:48

In Ovo Xenografting of Patient-Derived Acute Lymphoblastic Leukemia (ALL) Cells (PDX-ALL)

Published on: August 1, 2025

220

How much asparaginase is needed for optimal outcome in childhood acute lymphoblastic leukaemia? A systematic review

Leiah J Brigitha1, Rob Pieters1, Inge M van der Sluis1

  • 1Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.

European Journal of Cancer (Oxford, England : 1990)
|September 18, 2021
PubMed

Insights

Determining the optimal asparaginase dose is crucial for treating childhood acute lymphoblastic leukemia (ALL). While sufficient asparaginase activity is key, the duration of exposure significantly impacts treatment outcomes.

Area of Science:

  • Oncology
  • Pharmacology
  • Pediatrics

Background:

  • Asparaginase has been a cornerstone in treating childhood acute lymphoblastic leukemia (ALL) since the 1970s.
  • Optimal dosing strategies for asparaginase in pediatric ALL remain an area of active investigation.

Purpose of the Study:

  • To review the required asparaginase dose intensity for optimal outcomes in childhood ALL.
  • To evaluate the relationship between asparaginase exposure (level and duration) and treatment outcomes.

Main Methods:

  • Systematic literature search of PubMed and MEDLINE databases (January 1990 - March 2021).
  • Inclusion of 20 relevant papers focusing on asparaginase dose, activity levels, and patient outcomes.
  • Analysis based on pharmacokinetic profiles and target asparaginase activity levels (≥100 IU/L).

Main Results:

  • Therapeutic asparaginase activity levels (≥100 IU/L) were associated with outcomes, irrespective of the exact exposure level.
  • Duration of asparaginase exposure, measured by weeks of asparagine depletion, was found to affect outcomes.
  • No definitive cutoff for optimal exposure duration was established, with conflicting results from randomized controlled trials.

Conclusions:

  • Maintaining adequate asparaginase activity is essential for effective treatment of childhood ALL.
  • The duration of asparaginase therapy is a critical factor influencing treatment success.
  • Optimal exposure duration likely varies based on individual patient factors like immunophenotype, genetic subgroups, and risk stratification.

Keywords:
Acute lymphoblastic leukaemiaAsparaginaseDose intensityOutcomePediatric ALL

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