Recombinant crisantaspase: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
Recombinant crisantaspase: clinical details
Prescribing considerations
- Prescribe and administer within an experienced haemato-oncology service with anaphylaxis treatment and resuscitation facilities available.
- Record the product name and batch number for biological traceability.
- Consider appropriate premedication for intravenous administration.
- Do not substitute units used for other asparaginases or treat this product as interchangeable with another crisantaspase preparation.
- Evidence is insufficient to support recommendations in severe pre-existing hepatic or renal impairment.
Contraindications and cautions
- Previous severe hypersensitivity to recombinant crisantaspase
- Hypersensitivity to an excipient
- Current severe pancreatitis
- Previous severe pancreatitis during asparaginase treatment
- Previous severe thrombosis during asparaginase treatment
- Previous severe haemorrhage during asparaginase treatment
Monitoring
- Serum asparaginase activity, with individual adjustment by the specialist team where exposure is inadequate
- Clinical hypersensitivity and infusion reactions
- Blood count and signs of infection
- Blood glucose
- Bilirubin and transaminases
- Pancreatic symptoms and pancreatic enzymes when indicated
- Coagulation parameters and clinical evidence of thrombosis or bleeding
- Neurological symptoms, including features of encephalopathy or posterior reversible encephalopathy syndrome
Clinical pharmacology
A recombinant Erwinia chrysanthemi L-asparaginase produced using Pseudomonas fluorescens. Its amino-acid sequence matches native crisantaspase, and it hydrolyses circulating L-asparagine, selectively disadvantaging lymphoblastic cells with limited asparagine-synthetase capacity.
Formulation and product differences
- Ready-to-use solution suitable for intramuscular injection or dilution for intravenous infusion.
- Contains polysorbate 80, which can cause allergic reactions, and is essentially sodium-free.
- Must not be mixed with other medicines or infused through the same line except as specifically supported by the product instructions.
- Not interchangeable with other crisantaspase products when completing treatment.
Recombinant crisantaspase preparations and strengths
Injection
Route: Parenteral
Strengths: 10 mg/0.5 mL
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.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.