Asparaginase (L-asparaginase, E. coli) — Drug Monograph
Brand names: Elspar
Drug class: Other
Mechanism of Action
An enzyme (derived from E. coli) that hydrolyzes circulating L-asparagine to aspartic acid and ammonia, depleting extracellular asparagine. Normal cells synthesize asparagine via asparagine synthetase, but many lymphoblasts lack sufficient enzyme and depend on exogenous asparagine; depletion starves these cells of the amino acid needed for protein synthesis, causing selective leukemic cell death.
FDA Indications
- Acute lymphoblastic leukemia (ALL) — as a component of multi-agent combination chemotherapy
Common Side Effects
- Hypersensitivity reactions
- Nausea/vomiting
- Anorexia
- Fever
- Elevated liver enzymes
- Hyperglycemia
- Fatigue
Clinical Pearl
Asparaginase toxicity is distinct from typical chemotherapy — it does not cause marrow suppression or alopecia, but instead drives hypersensitivity, pancreatitis, thrombosis (from depleted antithrombin/fibrinogen), and hyperglycemia. Because clotting factor synthesis is impaired, patients can paradoxically both clot and bleed; monitor coagulation parameters. If an anaphylactic or hypersensitivity reaction occurs to the native E. coli product, switch to an Erwinia-derived asparaginase rather…
Related Therapies & Mechanisms
- Obecabtagene autoleucel (Aucatzyl) — Other · ALL
- Pegaspargase (pegylated L-asparaginase) (Oncaspar) — Other · ALL
- Adagrasib (Krazati) — Other
- Arsenic Trioxide (Trisenox) — Other