pegaspargase at a glance
Medicine class
Pegylated L-asparaginase enzyme
Main use
Part of combination treatment for acute lymphoblastic leukaemia
Administration
Given in hospital into a vein or muscle by an experienced cancer team
What is pegaspargase used for?
UK licensing covers use as one component of combination anticancer treatment.
Acute lymphoblastic leukaemia in adults.
Acute lymphoblastic leukaemia in children and adolescents, including treatment from birth.
How does pegaspargase work?
Pegaspargase breaks down the amino acid asparagine in the blood. Many ALL cells cannot make enough asparagine themselves, so depletion disrupts their protein, RNA and DNA production and promotes cell death. Attachment to polyethylene glycol changes how long the enzyme remains active and its immune recognition without changing its basic enzymatic action.
How to take pegaspargase
Pegaspargase is not taken at home or by mouth. Trained staff reconstitute the powder and give it as an intravenous infusion or intramuscular injection in hospital, where treatment for severe allergic reactions is available. Patients are monitored during and after administration.
Tell the team promptly about previous reactions to any asparaginase treatment.
Tell the team about all medicines, supplements and vaccinations before administration.
Food does not affect administration because pegaspargase is injected or infused.
pegaspargase side effects
Common or expected effects
- Nausea, diarrhoea, abdominal discomfort or reduced appetite
- Rash or hypersensitivity reactions
- Raised blood glucose or blood fats
- Changes in liver tests, pancreatic enzymes or blood-clotting tests
- Low albumin or reduced neutrophil count
- Febrile neutropenia
Get urgent medical advice
- Severe allergic reaction or anaphylaxis
- Pancreatitis, often causing severe abdominal pain that may spread to the back
- Blood clot, pulmonary embolism, stroke or serious bleeding
- Severe infection or fever with low white-cell counts
- Seizure, marked confusion or loss of consciousness
- Serious liver injury, including jaundice, liver failure or hepatic veno-occlusive disease
- Severe disturbance of blood glucose, including diabetic ketoacidosis
pegaspargase in pregnancy
There are no pregnancy data for pegaspargase, and related asparaginase studies in animals showed fetal harm. It should generally be avoided during pregnancy unless the specialist team considers treatment clinically necessary. Men and women should use effective contraception during treatment and for at least six months afterwards; oral contraception alone is not considered sufficiently reliable.
pegaspargase while breastfeeding
It is unknown whether pegaspargase enters breast milk, and harm to a breastfed child cannot be excluded. Breastfeeding should stop during treatment and should not restart until pegaspargase has been discontinued; discuss timing with the specialist team.
pegaspargase interactions
Pegaspargase can alter protein synthesis, liver function and clotting, affecting other treatments. The oncology team should review all medicines and planned vaccinations.
Warfarin, heparin, antiplatelets, aspirin and NSAIDs
Concurrent use may further increase bleeding or clotting complications and requires careful assessment and monitoring.
Glucocorticoids such as prednisone or dexamethasone
Clotting abnormalities may become more pronounced, and children and adolescents may have an increased risk of osteonecrosis.
Vincristine
Closely timed administration can increase toxicity, including vincristine-related neurotoxicity.
Common questions about pegaspargase
Answers are fully visible for fast scanning and source review.
What type of cancer is pegaspargase used to treat?
It is licensed as part of combination treatment for acute lymphoblastic leukaemia in adults and children, including babies.
Is pegaspargase a chemotherapy treatment?
It is an enzyme-based antineoplastic treatment. It works differently from conventional cytotoxic medicines but is used within a multi-medicine chemotherapy programme.
How is pegaspargase given?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.