Recombinant crisantaspase at a glance
Medicine class
Recombinant L-asparaginase anticancer enzyme
Usual role
Part of combination chemotherapy after hypersensitivity or silent inactivation to E. coli-derived asparaginase
Administration
Given by a healthcare professional into a muscle or by intravenous infusion
Treatment setting
Administered by an experienced cancer team where serious allergic reactions can be treated promptly
What is Recombinant crisantaspase used for?
Licensed uses as part of a multi-agent chemotherapy regimen:
Acute lymphoblastic leukaemia in adults and children aged at least one month who have developed hypersensitivity or silent inactivation to E. coli-derived asparaginase.
Lymphoblastic lymphoma in the same clinical context.
How does Recombinant crisantaspase work?
The enzyme breaks down circulating L-asparagine into L-aspartic acid and ammonia. Lymphoblastic cancer cells often cannot make enough asparagine, so depleting it restricts their survival and growth.
Recombinant crisantaspase preparations and strengths
Injection
Route: Parenteral
Strengths: 10 mg/0.5 mL
How to take Recombinant crisantaspase
The cancer team prepares and administers it as an intramuscular injection or intravenous infusion. Several injection sites may be needed for intramuscular administration. Paracetamol and antihistamines may be considered before intravenous administration to reduce infusion reactions.
Do not shake the vial during preparation.
Do not use the solution if particles or an abnormal appearance are present.
It is not taken by mouth, so food does not affect administration.
Recombinant crisantaspase side effects
Common or expected effects
- Low red cells, platelets, neutrophils or other white cells
- Fever, including fever with neutropenia
- Nausea, vomiting, diarrhoea or abdominal pain
- Tiredness, headache or reduced appetite
- High blood glucose
- Abnormal liver blood tests or low albumin
- Pain in a limb, bruising or anxiety
- Allergic skin reactions such as rash, itching or hives
Get urgent medical advice
- Severe allergic or infusion reaction, including anaphylaxis
- Pancreatitis
- Blood clot or serious bleeding
- Sepsis or fever with marked neutropenia
- Severe liver injury
- Seizures, encephalopathy or posterior reversible encephalopathy syndrome
Recombinant crisantaspase in pregnancy
There are no pregnancy data, and animal findings indicate potential harm to an embryo or fetus. It should generally be avoided during pregnancy unless the specialist team considers treatment clinically necessary. Pregnancy testing is advised before treatment, and effective non-hormonal contraception is recommended during treatment because an interaction with oral contraceptives cannot be excluded.
Recombinant crisantaspase while breastfeeding
Breastfeeding is not advised during treatment or for two weeks after the final administration because transfer into human milk is unknown and serious effects in a breastfed child are possible.
Recombinant crisantaspase interactions
Formal interaction studies have not been performed. The oncology team must consider treatment sequence and overlapping toxicities.
Vincristine
Concurrent or immediately preceding recombinant crisantaspase may reduce vincristine clearance and increase its toxicity.
Methotrexate or cytarabine
The sequence of administration may alter their anticancer effects, although the clinical importance is uncertain.
Glucocorticoids
Use with or immediately before recombinant crisantaspase may worsen changes in fibrinogen and antithrombin and affect clotting risk.
Common questions about Recombinant crisantaspase
Answers are fully visible for fast scanning and source review.
Why is it used after another asparaginase?
It provides asparaginase activity when an E. coli-derived product has caused hypersensitivity or has been silently inactivated.
Is it chemotherapy?
It is an enzyme-based antineoplastic treatment given as part of combination chemotherapy.
Can it treat both leukaemia and lymphoma?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.