Favorable remission induction rate with twice weekly doses of L-asparaginase.

Abstract

Summary Two dosage regimens of l-asparaginase were investigated to determine differences in the production of abnormal reactions and remission induction. Patients were randomly assigned to receive 200 i.u./kg daily for 14 days (Regimen A) or 1000 i.u./kg twice weekly for 2 weeks (Regimen B). All were in relapse and refractory to several chemotherapeutic agents. Median duration of disease was 11 months in Regimen A and 16 months in Regimen B. Three out of 16 patients in Regimen A and 7 out of 16 in Regimen B achieved a complete remission. Median duration of unmaintained remission was 33 days in Regimen A and 40 days in Regimen B. Upon relapse, reinduction was attempted in 9 patients at the original dosage. Complete remission was achieved in 1 out of 3 in Regimen A and 1 out of 6 in Regimen B (duration, 31 and 180 days, respectively). Six patients in each regimen experienced abnormal side effects comprising hypersensitivity reactions (3 in Regimen A and 4 in Regimen B), nausea, vomiting, cough, cyanosis, abdominal pain, and fever. One patient in Regimen A developed hyperglycemia without pancreatitis. The B regimen of l-asparaginase permitted less frequent clinic visits and a favorable remission induction rate without significant increase in toxicity.