Pronunciation:
kal-as-par-jase
Trade Name(s)
Ther. Class.
Pharm. Class.
enzymes
Acute lymphoblastic leukemia (ALL) (in combination with other chemotherapy agents).
Consists of l-asparaginase bound to monomethoxypolyethylene glycol (mPEG). This compound depletes asparagine (by converting it to aspartic acid and ammonia), which leukemic cells cannot synthesize. Normal cells are able to produce their own asparagine and are less susceptible to the effects of asparaginase. Binding to PEG renders asparaginase less antigenic and therefore less likely to induce hypersensitivity reactions.
Therapeutic Effect(s):
Death of leukemic cells.
Absorption: IV administration results in complete bioavailability.
Distribution: Not distributed well to tissues.
Metabolism and Excretion: Unknown.
Half-life: 16.1 days.
TIME/ACTION PROFILE (plasma concentrations)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
IV | unknown | 1.2 hr | unknown |
Contraindicated in:
Use Cautiously in:
CV: arrhythmias
GI: PANCREATITIS, HEPATOTOXICITY, ↑ bilirubin, ↑ liver enzymes, diarrhea
Hemat: THROMBOSIS, HEMORRHAGE
Resp: dyspnea
Misc: HYPERSENSITIVITY REACTIONS (including anaphylaxis and angioedema), INFECTION
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
Drug-Drug
May ↓ effectiveness of hormonal contraceptives.
IV (Adults and Children 1 mo-21 yr): 2500 units/m2 every 21 days.
Solution for injection : 750 units/mL
Monitor for signs and symptoms of hypersensitivity reactions (angioedema, lip swelling, eye swelling, erythema, blood pressure decreased, bronchospasm, dyspnea, pruritus, rash) during therapy. Administer only in clinical settings with resuscitation equipment and other agents to treat anaphylaxis (epinephrine, oxygen, intravenous steroids, antihistamines) and observe patients for 1 hr after administration. If Grade 1 reactions occur, reduce infusion rate by 50%. If Grade 2 reactions occur, hold infusion, treat symptoms, when symptoms resolve, resume infusion at 50% rate. If Grade 3 or 4 reactions occur, discontinue calaspargase permanently.
Assess for signs and symptoms of pancreatitis (severe abdominal pain, nausea, vomiting) during therapy. If Grade 3 or 4 symptoms occur, hold infusion for ↑ lipase or amylase >3 times ULN until levels stabilize or are declining. Discontinue calaspargase permanently if clinical pancreatitis is confirmed.
Monitor for signs and symptoms of thromboembolism (severe headache, arm or leg swelling, shortness of breath, chest pain) in extremity during therapy. If uncomplicated deep vein thrombosis occurs, hold infusion. Treat with antithrombotic therapy. When symptoms resolve consider continuing therapy while continuing antithrombotic therapy. If severe or life-threatening thrombosis occurs, discontinue permanently. Treat with antithrombotic therapy
Lab Test Considerations:
Verify negative pregnancy test before starting therapy.
High Alert: Fatalities have occurred with chemotherapeutic agents. Before administering, clarify all ambiguous orders; double check single, daily, and course-of-therapy dose limits; have second practitioner independently double check original order, dose calculations and infusion pump settings.
Advise patient to notify health care professional immediately if signs and symptoms of hypersensitivity, pancreatitis, thromboembolism, hemorrhage, or hepatotoxicity (jaundice, severe nausea or vomiting, easy bruising or bleeding) occur.
Improvement of hematologic status in patients with leukemia.