Bacterial asparaginase: A potential antineoplastic agent for treatment of acute lymphoblastic leukemia

Abstract

Among the pediatric cancer in developed countries, acute leukemia-constitutes major part with affecting 30-45 per 1,000,000 children each year. Although one thirds of acute lymphoblastic leukemia cases are curable, but the effect of treatment varies with differences in patients clinical, immunologic and genetic characteristics. L-asparaginase is among the main drugs used for the treatment of acute lymphoblastic leukemia and certain non Hodgkin lymphoma. L-asparaginase has been isolated from various sources including bacteria, algae, fungi, plant and mammals. Among these, bacterial asparaginase is most commonly used for treatment of ALL. But the efficacy of every asparaginase preparation varies in their activity, efficacy and side effects. This difference is reflected between the different marketed products even in bacterial asparaginase obtained from two different bacteria. Currently, native asparaginase obtained from E. coli and Erwinia chrysanthemi are most frequently used, but other products like PEG-asparaginase are also gaining popularity for management of ALL. Similarly, development of asparaginase in erythrocytes, asparaginase obtained from sources other than bacteria, and recombinant asparaginases are also a subject of research. Present chapter reviews the current status of bacterial asparaginase in ALL management, including its potential benefits, side effects and future research going in the direction of development of L-asparaginase as potential antineoplastic agent.