Asparaginase

Asparaginase (EC 3.5.1.1) is an enzyme which is used to treat acute lymphoblastic leukaemia (ALL). It is marketed under the brand name Elspar®. It can be given intramuscularly or intravenously.

Mechanism of action

The rationale behind asparaginase is that it takes advantage of the fact that ALL cells are unable to synthesize the non-essential amino acid asparagine whereas normal cells are able to make their own asparagine. These leukaemic cells depend on circulating asparagine. Asparaginase however catalyzes the conversion of L-asparagine to aspartic acid and ammonia. This deprives the leukaemic cell of circulating asparagine.

Side effects

The main side effect is an allergic or hypersensitivity reaction. Asparaginase has also been associated with pancreatitis. Additionally, it can also be associated with a coagulopathy as it decreases protein synthesis, including synthesis of coagulation factors and anticoagulant factor, leading to bleeding or thrombotic events.

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