Beard M E, Crowther D, Galton D A, Guyer R J, Fairley G H, Kay H E, Knapton P J, Malpas J S, Scott R B
Br Med J. 1970 Jan 24;1(5690):191-5. doi: 10.1136/bmj.1.5690.191.
L-Asparaginase was used to treat 40 patients with acute leukaemia or lymphosarcoma. Fifteen with acute lymphoblastic leukaemia either untreated or in relapse after previous therapy were given "Squibb," "Bayer," or "Porton" L-asparaginase. Five of these patients had complete remission of their disease, and four had good partial remission. Eleven patients with acute myeloid leukaemia were treated for a short period with L-asparaginase alone. None of them went into remission though a pronounced fall in the numbers of circulating white cells was seen. Six patients with lymphosarcoma received L-asparaginase, two of them having good partial remissions.The toxic side-effects of the L-asparaginase from the three sources seemed to vary, and L-asparaginase from Erwinia carotovora appeared to be antigenically different from the enzyme produced by Escherichia coli.The way in which leukaemic cells become resistant to the action of the enzyme requires further investigation. To overcome this resistance asparaginase should be used in combination with other drugs in the treatment of acute leukaemia.
左旋天冬酰胺酶用于治疗40例急性白血病或淋巴肉瘤患者。15例未经治疗或先前治疗后复发的急性淋巴细胞白血病患者接受了“施贵宝”、“拜耳”或“波顿”左旋天冬酰胺酶治疗。其中5例患者疾病完全缓解,4例患者部分缓解良好。11例急性髓细胞白血病患者仅接受了短期的左旋天冬酰胺酶治疗。尽管循环白细胞数量明显下降,但他们均未进入缓解期。6例淋巴肉瘤患者接受了左旋天冬酰胺酶治疗,其中2例部分缓解良好。来自三种来源的左旋天冬酰胺酶的毒副作用似乎有所不同,胡萝卜软腐欧文氏菌产生的左旋天冬酰胺酶在抗原性上似乎与大肠杆菌产生的酶不同。白血病细胞对该酶产生抗性的方式需要进一步研究。为克服这种抗性,在治疗急性白血病时应将天冬酰胺酶与其他药物联合使用。