Therapy with Erwinia l-asparaginase in children with acute leukemia after anaphylaxis to E. coli l-asparaginase

Abstract

Five pediatric leukemia patients being treated with 1-asparaginase derived from E. coli developed anaphylactic reactions to this enzyme which necessitated discontinuance of the drug. However, further therapy with Erwinia 1-asparaginase was well tolerated without untoward reactions or toxicities. Three patients achieved complete bone marrow remission (M1) on the 14th day of therapy, one patient achieved partial bone marrow remission (M2), and one had progressive disease. The availability of another active 1-asparaginase from a different microbiological source without immunologic cross reaction to E. coli-derived 1-asparaginase may help to alleviate the problem of anaphylactic reactions to E. coli 1-asparaginase.