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CALASPARGASE PEGOL
Generic Name: CALASPARGASE PEGOL
ABSTRACT -
Calaspargase pegol (Asparlas) is an FDA-approved PEGylated recombinant L-asparaginase for the treatment of acute lymphoblastic leukaemia (ALL) as part of a multi-agent chemotherapy regimen in patients aged 1 month and older. Leukaemic cells lack asparagine synthetase and depend on circulating asparagine; calaspargase pegol depletes serum asparagine, selectively starving ALL cells. Its extended half-life allows less frequent dosing than native asparaginase.
DOSAGE -
2500 IU/m² intravenously or intramuscularly, administered no more frequently than every 21 days as part of the ALL treatment regimen.
SIDE EFFECTS -
- Pancreatitis
- Hepatotoxicity (elevated LFTs, coagulopathy)
- Hypersensitivity reactions
- Thrombosis (including cerebral sinus thrombosis)
- Hyperglycaemia
ALLERGIC REACTIONS -
These symptoms may indicate an allergic reaction and require immediate medical attention.
- Anaphylaxis (switch to non-PEGylated or Erwinia asparaginase)
- Severe hypersensitivity with urticaria
- Angioedema
- Serum sickness
DRUG INTERACTIONS-
- Methotrexate efficacy may be altered by asparagine depletion
- Vincristine neuropathy may be exacerbated
- Monitor coagulation when combined with anticoagulants
PREAUTONS–
- Monitor amylase, lipase, LFTs, coagulation panel before each dose
- Switch to alternative asparaginase preparation if Grade ≥2 hypersensitivity
- Thrombosis risk — anticoagulant prophylaxis may be warranted
- Pancreatitis — withhold and do not re-challenge if confirmed
WARNINGS –
- Pancreatitis including haemorrhagic and fatal cases reported
- Serious thrombotic events including sagittal sinus thrombosis
- Hepatotoxicity with coagulopathy requiring FFP/cryoprecipitate
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