培门冬酶治疗儿童白血病研究进展

Advances on the role of pegaspargase in the treatment of childhood leukemia

左旋门冬酰胺酶(L-asparaginase,L-asp)作为治疗急性淋巴细胞白血病(ALL)化疗药物重要组成已超过30年,可明显改善儿童ALL的远期疗效。然而,L-asp的高不良反应发生率促使了培门冬酶(pegaspargase,PEG-asp)的发展,已有大量研究证明,PEG-asp在保留了L-asp的抗肿瘤活性的基础上,半衰期较L-asp明显延长,且存在降低不良反应发生率的潜在优势。该文概述L-asp的研究与临床应用历史、PEGasp的发展进程,归纳文献资料评估不同种类L-asp的药理学潜力与临床疗效,以及PEG-asp临床应用情况与不良反应实际发生率。该文收集了所有网上已发表的、可供分析的PEG-asp临床资料,希望能为临床提供参考。

The chemotherapy agent L-asparaginase （L-asp） has been an important part of acute lymphoblastic leukemia therapy for over 30 years. It is evident that L-asp has a long-term curative effect. However, L-asp is associated with high incidence of adverse reactions. This has prompted the development of pegylated asparaginase （PEG-asp）, which has undergone extensive testing. Apparently, PEG-asp has a prolonged half-life with a better tolerance profile while retaining the antileukemic effect. In this review, we attempt to outline the history of clinical application of L-asp, the pharmacological and clinical potential of various preparations ofL-asp, the development of PEG-asp, and the clinical application and adverse events of PEG-asp. The literatures reviewed in this article is collected through online search of the major databases both in English and Chinese.