Thomas Xavier, Le Jeune Caroline
Hospices Civils de Lyon, Hematology Department, Lyon-Sud Hospital, Bât.1G, 165 chemin du Grand Revoyet, 69495 Pierre-Bénite, France.
Int J Hematol Oncol. 2016 May;5(1):11-25. doi: 10.2217/ijh-2016-0002. Epub 2016 May 5.
l-asparaginase, an enzyme originally derived from , represents a major drug in the treatment of acute lymphoblastic leukemia. However, the occurrence of major adverse effects often leads to early withdrawal of the enzyme. Main side effects include immune-allergic reactions, coagulopathy, pancreatitis and hepatic disorders. Novel asparaginase formulations and alternative sources have been developed to address this issue, but the results were not totally satisfactory. l-asparaginase loaded red blood cells (RBCs; GRASPA) represent a new asparaginase presentation with reduced immunological adverse reactions. RBCs protect l-asparaginase, enhance its half-life and reduce the occurrence of adverse events. We reviewed the history, biology and clinical experiences with l-asparaginase, and the characteristics and first clinical experiences with GRASPA in the treatment of acute leukemia.
L-天冬酰胺酶最初从 中提取，是治疗急性淋巴细胞白血病的一种主要药物。然而，严重不良反应的发生常常导致该酶的早期停用。主要副作用包括免疫过敏反应、凝血病、胰腺炎和肝脏疾病。为解决这一问题，已研发出新型天冬酰胺酶制剂和替代来源，但结果并不完全令人满意。负载L-天冬酰胺酶的红细胞（GRASPA）是一种新的天冬酰胺酶制剂，其免疫不良反应有所减少。红细胞可保护L-天冬酰胺酶，延长其半衰期并减少不良事件的发生。我们回顾了L-天冬酰胺酶的历史、生物学特性和临床经验，以及GRASPA治疗急性白血病的特点和首次临床经验。
