门冬酰胺酶在急性淋巴细胞白血病治疗中的副作用及其对策

L-asparaginase’s side effects in therapy for acute lymphoblastic leukemia and prophylaxis measures

门冬酰胺酶(L-ASP)是治疗成人和儿童急性淋巴细胞白血病的有效药物,几乎包含在所有的ALL治疗方案中。尽管该药耗竭天冬氨酸的独特作用机理使其对肿瘤细胞具有相对物异性,但部分病人仍在治疗过程中出现各种副反应。L-ASP治疗的严重并发症主要有过敏反应、急性胰腺炎和血栓形成。为预防和早期诊断各种并发症,在L-ASP治疗过程中或治疗后需进行密切的临床和相关实验指标如抗凝血酶和血清淀粉酶观察。

L - asparaginase（ L - ASP） is a very effective therapeutic drug in acute lymphoblastie leukemia for both adult and pediatric patients and included in nearly every ALL protocol. Despite the unique mechanism of action of this drug which shows relative selectivity with regard to the metabolism of malignant cells by catalyzing the hydrolysis of L - asparagine, some patients experience toxic effects during asparaginase therapy. L - ASP treatment is associated with some serious complications such as alleregy, acute pancreatitis and thromboembolic events. For prophylaxis and early diagnosis, very close observation of the clinical symptoms and laboratory tests such antithrombin and serum amylase are necessary during or after the treatment with L - ASP.