L-asparaginase is a universal component of treatment for childhood acute lymphoblastic leukaemia, and is usually administered intramuscularly. Pegylated E coli asparaginase (PEG-asparaginase) has a longer half-life and is postulated to be potentially less immunogenic than the native E coli preparation, and could be more feasibly administered intravenously.
According to a comment article, the findings of this and other recent studies reinforce the idea that intravenous PEG-asparaginase is the preparation that should be used in modern clinical trials commencing with the first planned exposure to the drug in the treatment schedule. The commentator notes that this option reduces the number of hospital visits and the frequency of immunological and product shifts, and thus additional treatment costs. Moreover, when administered intravenously, this treatment results in less anxiety for patients and parents. Ongoing protocols from different cooperative groups have adopted this approach. He hopes that additional information will be available soon to enable the selection of not only the best asparaginase preparation but also the best schedule and treatment drug monitoring programme.