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Clinical Medicine Insights: Oncology

Update on the Use of l-Asparaginase in Infants and Adolescent Patients with Acute Lymphoblastic Leukemia

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Clinical Medicine Insights: Oncology 2014:8 95-100

Review

Published on 24 Aug 2014

DOI: 10.4137/CMO.S10242


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Abstract

Great improvements have been made in acute lymphoblastic leukemia (ALL) treatment in the past decades, especially due to the use of l-asparaginase (l-ASP). Despite the significant success rate, several side effects mainly caused by toxicity, asparaginase silent inactivation, and cellular resistance, encourage an open debate regarding the optimal dosage and formulation of l-ASP. Alternative sources of asparaginases have been constantly investigated in order to overcome hypersensitivity clinical toxicity. Additionally, genomic modulation as gene expression profiling, genetic polymorphisms, and epigenetic changes is also being investigated concerning their role in cellular resistance to l-ASP. Understanding the mechanisms that mediate the resistance to l-ASP treatment may bring new insights into ALL pathobiology and contribute to the development of more effective treatment strategies. In summary, this review presents an overview on l-ASP data and focuses on cellular mechanisms underlying resistance and alternative therapies for the use of asparaginase in childhood ALL treatment.



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It is an honor that my manuscript was accepted by the Clinical Medicine Insights: Oncology.  The comments from reviewers were professional, the emails from the editor were friendly, and the procedure was very quick.  I will submit further manuscripts to Clinical Medicine Insights: Oncology in the near future.
Dr Cheng Tan (Hamamatsu University School of Medicine, Shizuoka, Japan)
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