What is Asparaginase?

Asparaginase is an enzyme which is used in the body to speed up the change of asparagine into products called aspartic acid and ammonia. It is usually harvested from a microorganism called Escherichia coli (E. coli). Asparaginase is used in both pharmaceuticals and industrial food packaging. In the packaging of food products, it is an additive that prevents starchy foods from developing a carcinogen called acrylamide. Medicinally, it is used in treatment plans for acute lymphoblastic leukemia (ALL).

The enzyme treats leukemia by removing the asparagine in the body that malignant cancer cells feed on to survive. Asparagine is used by all cells for nutrition, but only cancer cells are unable to manufacture their own. The cancer cells are not able to grow and reproduce because the asparagine is turned into aspartic acid and ammonia by the administration of asparaginase in the form of the drug Elspar®. This drug is effective for most patients diagnosed with acute lymphoblastic leukemia.

Elspar® is given intravenously or through an injection into the muscles of the legs. The dosage varies greatly depending on the height and weight of the patient being treated. There are many reports of anaphylactic allergic reactions to the medicine, so all patients are given a test dose before beginning therapy for cancer. Other serious side effects are pancreatitis, stroke, and an increase in blood glucose levels. Liver enzymes may become elevated during the course of treatment, but they usually return to normal once the drug is discontinued.

The most common side effects of asparaginase are flu-like symptoms including fever, nausea, chills, and vomiting. A few patients experience excessive sleepiness and depression. It is possible to have hallucinations while being treated with asparaginase. Some have reported seizures and confusion as a result of taking this medication. The confusion and sleepiness are caused by the increase in aspartic acid and ammonia circulating in the blood.

Asparaginase is classified as a category C risk for pregnancy. It is not advisable to become pregnant or father a child while being treated with it. Women who have already given birth are cautioned not to breast-feed, as the medication can pass through breast milk. Additionally, there is a known risk to receiving immunizations while on treatment with Elspar®.

During cancer treatment with asparaginase, it is common to have blood work done frequently to test for the proper functioning of the liver and other organs. The blood will be tested for elevated pancreatic enzymes and for blood clotting factor times. An increase in the clotting factor can signal a higher risk for stroke. Blood sugar will be monitored to ensure that an increase to dangerous levels does not occur as a result of treatment.