Asparaginase

{{Short description|Enzyme used as medication and in food manufacturing}} {{Use dmy dates|date=June 2023}} {{cs1 config |name-list-style=vanc |display-authors=6}} {{Infobox drug | Verifiedfields = changed | verifiedrevid = 458472067 | image = 3eca.jpg | width = 270 | alt = | caption =  | pronounce = | tradename = Elspar, Leunase, Rylaze, Spectrila, others | Drugs.com = {{drugs.com|monograph|asparaginase}} | MedlinePlus = a682046 | licence_EU = yes | DailyMedID = Asparaginase | pregnancy_AU = D | pregnancy_AU_comment = <ref name="Erwinase APMDS">{{cite web | title=Erwinase APMDS | website=Therapeutic Goods Administration (TGA) | date=27 February 2024 | url=https://www.tga.gov.au/resources/auspmd/erwinase | access-date=7 March 2024 | archive-date=10 March 2024 | archive-url=https://web.archive.org/web/20240310055052/https://www.tga.gov.au/resources/auspmd/erwinase | url-status=live }}</ref> | pregnancy_category = | routes_of_administration = Intramuscular, intravenous | class = Antineoplastic | ATCvet = | ATC_prefix = L01 | ATC_suffix = XX02 | ATC_supplemental = | biosimilars =  | legal_AU = S4 | legal_AU_comment = <ref name="Erwinase APMDS" /> | legal_BR =  | legal_BR_comment = | legal_CA = Rx-only | legal_CA_comment = | legal_DE =  | legal_DE_comment = | legal_NZ =  | legal_NZ_comment = | legal_UK = POM | legal_UK_comment = <ref name="Spectrila SmPC" /> | legal_US = Rx-only | legal_US_comment = <ref name="Rylaze FDA label">{{cite web | title=Rylaze (asparaginase erwinia chrysanthemi- recombinant-rywn) injection | website=DailyMed | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=857e53aa-1098-4dad-b654-0276cdd43e03 | access-date=20 August 2021 | archive-date=15 August 2021 | archive-url=https://web.archive.org/web/20210815113421/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=857e53aa-1098-4dad-b654-0276cdd43e03 | url-status=live }}</ref> | legal_EU = Rx-only | legal_EU_comment = <ref>{{cite web|url=https://www.ema.europa.eu/documents/psusa/asparaginase-crisantaspase-nationally-authorised-products-list-nationally-authorised-medicinal/00003161/202108_en.pdf|title=List of nationally authorised medicinal products: Active substance: asparaginase, crisantaspase. Procedure no.: PSUSA/00003161/202108|website=Ema.europa.eu|access-date=20 July 2022|archive-date=10 March 2024|archive-url=https://web.archive.org/web/20240310055044/https://www.ema.europa.eu/en/documents/psusa/asparaginase-crisantaspase-nationally-authorised-products-list-nationally-authorised-medicinal-products-psusa00003161202108_en.pdf|url-status=live}}</ref><ref name="Enrylaze EPAR">{{cite web | title=Enrylaze EPAR | website=European Medicines Agency | date=5 October 2023 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/enrylaze | access-date=5 October 2023 | archive-date=17 February 2024 | archive-url=https://web.archive.org/web/20240217185459/https://www.ema.europa.eu/en/medicines/human/EPAR/enrylaze | url-status=live }}</ref> | legal_UN =  | legal_UN_comment = | legal_status = Rx-only

| bioavailability = | protein_bound = | metabolism = | metabolites = | onset = | elimination_half-life = 39-49 hours (IM), 8-30 hours (IV) | duration_of_action = | excretion =  | CAS_number_Ref = {{cascite|correct|??}} | CAS_number = 9015-68-3 | CAS_supplemental = | PubChem = | IUPHAR_ligand = 7347 | DrugBank_Ref = {{drugbankcite|correct|drugbank}} | DrugBank = DB00023 | ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}} | ChemSpiderID = none | UNII_Ref = {{fdacite|correct|FDA}} | UNII = G4FQ3CKY5R | KEGG_Ref = {{keggcite|correct|kegg}} | KEGG = D02997 | ChEBI = | ChEMBL = | NIAID_ChemDB = | PDB_ligand = | synonyms = crisantaspase, colaspase, asparaginase erwinia chrysanthemi (recombinant)-rywn

| IUPAC_name = E. coli L-asparagine amidohydrolase | C = 1377 | H = 2208 | N = 382 | O = 442 | S = 17 | SMILES = | StdInChI = | StdInChI_comment = | StdInChIKey = | density = | density_notes = | melting_point = | melting_high = | melting_notes = | boiling_point = | boiling_notes = | solubility = | sol_units = | specific_rotation = }}

'''Asparaginase''' is an enzyme that is used as a medication and in food manufacturing.<ref name=AHFS2016/><ref name=Go2015/> As a medication, L-asparaginase is used to treat acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL).<ref name=AHFS2016/> It is given by injection into a vein, or muscle.<ref name=AHFS2016/> A PEGylated version, pegaspargase, is also available.<ref name=Kim2016/> In food manufacturing it is used to decrease acrylamide.<ref name=Go2015>{{cite book | vauthors = Gökmen V |title=Acrylamide in Food: Analysis, Content and Potential Health Effects|date=2015|publisher=Academic Press |isbn=978-0-12-802875-9 |page=415 |url=https://books.google.com/books?id=iFmZBQAAQBAJ&pg=PA415|url-status=live|archive-url=https://web.archive.org/web/20161221162418/https://books.google.ca/books?id=iFmZBQAAQBAJ&pg=PA415|archive-date=21 December 2016}}</ref>

Common side effects when used by injection include allergic reactions, pancreatitis, blood clotting problems, high blood sugar, kidney problems, and liver dysfunction.<ref name=AHFS2016>{{cite web|title=Asparaginase|url=https://www.drugs.com/monograph/asparaginase.html|publisher=The American Society of Health-System Pharmacists|access-date=8 December 2016|url-status=live|archive-url=https://web.archive.org/web/20170327202623/https://www.drugs.com/monograph/asparaginase.html|archive-date=27 March 2017}}</ref> Use in pregnancy may harm the baby.<ref>{{cite web|title=Asparaginase escherichia coli (Elspar) Use During Pregnancy|url=https://www.drugs.com/pregnancy/asparaginase-escherichia-coli.html|website=www.drugs.com|access-date=20 December 2016|url-status=live|archive-url=https://web.archive.org/web/20170327153337/https://www.drugs.com/pregnancy/asparaginase-escherichia-coli.html|archive-date=27 March 2017}}</ref> As a food it is generally recognized as safe.<ref name=Go2015/> Asparaginase works by breaking down the amino acid known as asparagine without which the cancer cells cannot make protein.<ref name=AHFS2016/>

Asparaginase was approved for medical use in the United States in 1978.<ref name=Kim2016>{{cite book| vauthors = Kim KW, Roh JK, Wee HJ, Kim C |title=Cancer Drug Discovery: Science and History |date=2016 |publisher=Springer |isbn=978-94-024-0844-7 |page=147 |url= https://books.google.com/books?id=BR9_DQAAQBAJ&pg=PA147 |url-status=live|archive-url=https://web.archive.org/web/20161221162218/https://books.google.ca/books?id=BR9_DQAAQBAJ&pg=PA147 |archive-date=21 December 2016}}</ref> It is on the World Health Organization's List of Essential Medicines.<ref name="WHO21st">{{cite book | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06 | hdl-access=free }}</ref> It is often made from ''Escherichia coli'' (''E. coli'') or ''Erwinia chrysanthemi''.<ref name=Kim2016/><ref>{{cite book| vauthors = Farmer PB, Walker JM |title=The Molecular Basis of Cancer|date=2012|publisher=Springer Science & Business Media |isbn=978-1-4684-7313-1 |page=279 |url=https://books.google.com/books?id=Bva8BAAAQBAJ&pg=PA279|url-status=live|archive-url=https://web.archive.org/web/20161221161354/https://books.google.ca/books?id=Bva8BAAAQBAJ&pg=PA279|archive-date=21 December 2016}}</ref>

== Development of the drug == In 1963, asparaginase (ASNase) was identified as an effective antileukemic agent, and subsequent efforts were made to isolate it from bacterial sources and scale up production for clinical trials.<ref name="Development of asparaginase Erwinia">{{cite journal | vauthors = Salzer WL, Asselin BL, Plourde PV, Corn T, Hunger SP | title = Development of asparaginase Erwinia chrysanthemi for the treatment of acute lymphoblastic leukemia | journal = Annals of the New York Academy of Sciences | volume = 1329 | issue = 1 | pages = 81–92 | date = November 2014 | pmid = 25098829 | doi = 10.1111/nyas.12496 | bibcode = 2014NYASA1329...81S | s2cid = 25278669 | doi-access = free }}</ref> Clinical testing with bacterial-derived ASNase commenced in 1966, and in 1978, ''E''.'' coli''–derived ASNase received approval from the United States for the treatment of acute lymphoblastic leukemia.<ref name=":0">{{cite journal | vauthors = Asselin BL, Devidas M, Wang C, Pullen J, Borowitz MJ, Hutchison R, Lipshultz SE, Camitta BM | title = Effectiveness of high-dose methotrexate in T-cell lymphoblastic leukemia and advanced-stage lymphoblastic lymphoma: a randomized study by the Children's Oncology Group (POG 9404) | journal = Blood | volume = 118 | issue = 4 | pages = 874–883 | date = July 2011 | pmid = 21474675 | pmc = 3292437 | doi = 10.1182/blood-2010-06-292615 }}</ref> Subsequently, pegylated ''E''.'' coli'' ASNase was approved in 1994 as a second-line treatment and later in 2006 as a first-line treatment for acute lymphoblastic leukemia.<ref name=":0" /> Another ASNase variant, ASNase Erwinia chrysantemi, obtained authorization for use in the United Kingdom in 1985, and gained approval from the US Food and Drug Administration in 2011.<ref name="Development of asparaginase Erwinia"/>

==Uses== Asparaginases are primarily used as pharmaceuticals and as industrial food processing agents.

===Medical=== ''E. coli'' strains are the main source of medical asparaginase.<ref name="js" /> Branded formulations (with different chemical and pharmacological properties) available in 1998 include Asparaginase Medac, Ciderolase, and Oncaspar.<ref name="js" />{{rp|5}} (Crasnitin has been discontinued.) Spectrila is a recombinant ''E. coli'' asparaginase.<ref name="Spectrila SmPC">{{cite web |url=https://www.medicines.org.uk/emc/medicine/32147 |title=Spectrila 10,000 U powder for concentrate for solution for infusion - Summary of Product Characteristics (SmPC) - (eMC) |access-date=8 November 2016 |url-status=live |archive-url=https://web.archive.org/web/20161109022458/https://www.medicines.org.uk/emc/medicine/32147 |archive-date=9 November 2016 }}</ref>

Asparaginase produced by ''Dickeya dadantii'' (formerly called ''Erwinia chrysanthemi'') instead is known as crisantaspase (BAN), and is available in the United Kingdom under the brand name Erwinase.<ref name=BNF57>{{cite book |title=British National Formulary (BNF 57) |date=March 2009 |publisher=BMJ Group and RPS Publishing |location=United Kingdom |isbn=978-0-85369-845-6 |page=476 |chapter=8.1.5: Other antineoplastic drugs |author8=British Medical Association, Royal Pharmaceutical Society of Great Britain|title-link=British National Formulary }}</ref>

One of the ''E. coli'' asparaginases marketed under the brand name Elspar for the treatment of acute lymphoblastic leukemia<ref name=BNF57/> is also used in some mast cell tumor protocols.<ref name="pmid17554375">{{cite journal | vauthors = Appel IM, van Kessel-Bakvis C, Stigter R, Pieters R | title = Influence of two different regimens of concomitant treatment with asparaginase and dexamethasone on hemostasis in childhood acute lymphoblastic leukemia | journal = Leukemia | volume = 21 | issue = 11 | pages = 2377–2380 | date = November 2007 | pmid = 17554375 | doi = 10.1038/sj.leu.2404793 | doi-access = free }}</ref>

In July 2006, the US Food and Drug Administration (FDA) granted approval to pegaspargase for the first-line treatment of people with acute lymphoblastic leukemia as a component of a multiagent chemotherapy regimen. Pegaspargase was previously approved in February 1994 for the treatment of patients with acute lymphoblastic leukemia who were hypersensitive to native forms of L-asparaginase.<ref>{{cite journal | vauthors = Dinndorf PA, Gootenberg J, Cohen MH, Keegan P, Pazdur R | title = FDA drug approval summary: pegaspargase (oncaspar) for the first-line treatment of children with acute lymphoblastic leukemia (ALL) | journal = The Oncologist | volume = 12 | issue = 8 | pages = 991–998 | date = August 2007 | pmid = 17766659 | doi = 10.1634/theoncologist.12-8-991 | s2cid = 43076064 }}</ref><ref>{{cite web |title=FDA Approves Oncaspar for First-Line ALL |series=Oncology NEWS International Vol 15 No 8 |url=https://www.cancernetwork.com/view/fda-approves-oncaspar-first-line-all |date=1 August 2006 |volume=15 |issue=8 |access-date=21 November 2022 |archive-date=21 November 2022 |archive-url=https://web.archive.org/web/20221121103049/https://www.cancernetwork.com/view/fda-approves-oncaspar-first-line-all |url-status=live }}</ref><ref>{{cite web |title=FDA Approval for Pegaspargase |url=https://www.cancer.gov/about-cancer/treatment/drugs/fda-pegaspargase |publisher=National Cancer Institute |access-date=21 November 2022 |archive-url=https://web.archive.org/web/20170609070529/https://www.cancer.gov/about-cancer/treatment/drugs/fda-pegaspargase |archive-date=9 June 2017 |date=3 July 2013}} {{PD-notice}}</ref> Similar designations were later applied to calaspargase (December 2018) and asparaginase erwinia chrysanthemi (June 2021), both identified as orphan drugs.<ref>{{cite journal |title=FDA Approves New Enzyme Product for ALL |journal=Medscape |url=https://www.medscape.com/viewarticle/906923 |access-date=21 November 2022 |archive-date=21 November 2022 |archive-url=https://web.archive.org/web/20221121103048/https://www.medscape.com/viewarticle/906923 |url-status=live }}</ref><ref>{{cite press release | publisher=Jazz Pharmaceuticals plc | title=Jazz Pharmaceuticals Announces U.S. FDA Approval of Rylaze (asparaginase erwinia chrysanthemi (recombinant)-rywn) for the Treatment of Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma | via=PR Newswire | date=30 June 2021 | url=https://www.prnewswire.com/news-releases/jazz-pharmaceuticals-announces-us-fda-approval-of-rylaze-asparaginase-erwinia-chrysanthemi-recombinant-rywn-for-the-treatment-of-acute-lymphoblastic-leukemia-or-lymphoblastic-lymphoma-301323782.html | access-date=1 July 2021 | archive-date=1 July 2021 | archive-url=https://web.archive.org/web/20210701004954/https://www.prnewswire.com/news-releases/jazz-pharmaceuticals-announces-us-fda-approval-of-rylaze-asparaginase-erwinia-chrysanthemi-recombinant-rywn-for-the-treatment-of-acute-lymphoblastic-leukemia-or-lymphoblastic-lymphoma-301323782.html | url-status=live }}</ref>

===As a food processing aid=== Acrylamide is often formed in the cooking of starchy foods. During heating, asparagine undergoes the Maillard reaction, giving baked or fried foods their brown color and toasted flavor, but also producing carcinogens such as acrylamide. Addition of asparaginase before cooking destroys asparagine so that the formation of acrylamide is significantly reduced.<ref name="kornbrust">{{cite book | vauthors = Kornbrust BA, Stringer MA, Lange NE, van Oort M |date=September 22, 2009 | veditors = Whitehurst RJ, van Oort M |title=Enzymes in Food Technology |publisher=Blackwell Publishing Ltd |pages=59–87 |chapter=Chapter 4: Asparaginase - An Enzyme for Acrylamide Reduction in Food Products |isbn=978-1-4443-0993-5}}</ref>

===As a drug=== Applications of asparaginase in cancer therapy take advantage of the fact that acute lymphoblastic leukemia cells and some other suspected tumor cells are unable to synthesize the non-essential amino acid asparagine, whereas normal cells are able to make their own asparagine; thus leukemic cells require a high amount of asparagine.<ref>{{cite journal | vauthors = Fernandes HS, Silva Teixeira CS, Fernandes PA, Ramos MJ, Cerqueira NM | title = Amino acid deprivation using enzymes as a targeted therapy for cancer and viral infections | journal = Expert Opinion on Therapeutic Patents | volume = 27 | issue = 3 | pages = 283–297 | date = March 2017 | pmid = 27813440 | doi = 10.1080/13543776.2017.1254194 | s2cid = 7768944 }}</ref> These leukemic cells depend on circulating asparagine. Asparaginase, however, catalyzes the conversion of <small>L</small>-asparagine to aspartic acid and ammonia. This deprives the leukemic cell of circulating asparagine, which leads to cell death.<ref>{{cite journal | vauthors = Broome JD | title = L-Asparaginase: discovery and development as a tumor-inhibitory agent | journal = Cancer Treatment Reports | volume = 65 | issue = Suppl 4 | pages = 111–114 | year = 1981 | pmid = 7049374 }}</ref>

==Side effects== The main side effect is an allergic or hypersensitivity reaction; anaphylaxis is a possibility.<ref name=BNF57/> Additionally, it can also be associated with a coagulopathy as it decreases protein synthesis, including synthesis of coagulation factors (e.g. progressive isolated decrease of fibrinogen) and anticoagulant factor (generally antithrombin III; sometimes protein C and S as well), leading to bleeding or thrombotic events such as stroke.<ref name="js">{{cite journal | vauthors = Avramis VI, Sencer S, Periclou AP, Sather H, Bostrom BC, Cohen LJ, Ettinger AG, Ettinger LJ, Franklin J, Gaynon PS, Hilden JM, Lange B, Majlessipour F, Mathew P, Needle M, Neglia J, Reaman G, Holcenberg JS, Stork L | title = A randomized comparison of native Escherichia coli asparaginase and polyethylene glycol conjugated asparaginase for treatment of children with newly diagnosed standard-risk acute lymphoblastic leukemia: a Children's Cancer Group study | journal = Blood | volume = 99 | issue = 6 | pages = 1986–1994 | date = March 2002 | pmid = 11877270 | doi = 10.1016/S1040-8428(98)00015-8 }}</ref> Bone marrow suppression is common but only mild to moderate, rarely reaches clinical significance and therapeutic consequences are rarely required.<ref>{{cite journal | vauthors = Johnston PG, Hardisty RM, Kay HE, Smith PG | title = Myelosuppressive effect of colaspase (L-asparaginase) in initial treatment of acute lymphoblastic leukaemia | journal = British Medical Journal | volume = 3 | issue = 5923 | pages = 81–83 | date = July 1974 | pmid = 4604804 | pmc = 1611087 | doi = 10.1136/bmj.3.5923.81 }}</ref>

The most common nonhematological adverse reactions of asparaginase erwinia chrysanthemi (recombinant) include abnormal liver test, nausea, musculoskeletal pain, infection, fatigue, headache, febrile neutropenia, pyrexia, hemorrhage (bleeding), stomatitis, abdominal pain, decreased appetite, drug hypersensitivity, hyperglycemia, diarrhea, pancreatitis, and hypokalemia.<ref name="FDA Rylaze">{{cite web | title=FDA approves asparaginase erwinia chrysanthemi (recombinant) for leukemia and lymphoma | website=U.S. Food and Drug Administration (FDA) | date=1 July 2021 | url=https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-asparaginase-erwinia-chrysanthemi-recombinant-leukemia-and-lymphoma | access-date=1 July 2021 | archive-date=1 July 2021 | archive-url=https://web.archive.org/web/20210701134209/https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-asparaginase-erwinia-chrysanthemi-recombinant-leukemia-and-lymphoma }} {{PD-notice}}</ref><ref name="FDA Rylaze 2">{{cite web | title=FDA approves a new dosing regimen for asparaginase erwinia chrysanthemi (recombinant) | website=U.S. Food and Drug Administration (FDA) | date=18 November 2022 | url=https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-new-dosing-regimen-asparaginase-erwinia-chrysanthemi-recombinant | access-date=22 November 2022 | archive-date=22 November 2022 | archive-url=https://web.archive.org/web/20221122011845/https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-new-dosing-regimen-asparaginase-erwinia-chrysanthemi-recombinant }} {{PD-notice}}</ref> The most common side effects of asparaginase erwinia chrysanthemi (recombinant) when given in combination with chemotherapy for the treatment of acute lymphoblastic leukemia and lymphoblastic lymphoma are abnormal liver tests, nausea, muscle and bone pain, and fatigue.<ref name="Drug Trials Snapshots: Rylaze">{{cite web | title=Drug Trials Snapshots: Rylaze | website=U.S. Food and Drug Administration (FDA) | date=18 May 2023 | url=https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trials-snapshots-rylaze | access-date=3 June 2023 | archive-date=10 March 2024 | archive-url=https://web.archive.org/web/20240310055103/https://www.fda.gov/drugs/drug-approvals-and-databases/drug-trials-snapshots-rylaze }} {{PD-notice}}</ref>

==History== The discovery and development of asparaginase as an anti-cancer drug began in 1953, when scientists first observed that lymphomas in rat and mice regressed after treatment with guinea pig serum.<ref>{{cite journal | vauthors = Kidd JG | title = Regression of transplanted lymphomas induced in vivo by means of normal guinea pig serum. I. Course of transplanted cancers of various kinds in mice and rats given guinea pig serum, horse serum, or rabbit serum | journal = The Journal of Experimental Medicine | volume = 98 | issue = 6 | pages = 565–582 | date = December 1953 | pmid = 13109110 | pmc = 2136344 | doi = 10.1084/jem.98.6.565 }}</ref> Later it was found out that it is not the serum itself which provoke the tumour regression, but rather the enzyme asparaginase.<ref>{{cite journal | vauthors = Broome JD | title = Evidence that the L-asparaginase of guinea pig serum is responsible for its antilymphoma effects. I. Properties of the L-asparaginase of guinea pig serum in relation to those of the antilymphoma substance | journal = The Journal of Experimental Medicine | volume = 118 | issue = 1 | pages = 99–120 | date = July 1963 | pmid = 14015821 | pmc = 2137570 | doi = 10.1084/jem.118.1.99 }}</ref>

After researchers comparing different kinds of asparaginases, the one derived from ''Escherichia coli'' and ''Erwinia chrysanthemi'' turned out to have the best anti-cancer ability. ''E. coli'' has thereby become the main source of asparaginase due to the factor that it is also easy to produce in large amounts.<ref name="js" />

==Names and synonyms==

Crisantaspase is the British Approved Name (BAN) for asparaginase obtained from ''Erwinia chrysanthemi''. Colaspase is the BAN of asparaginase obtained from ''Escherichia coli''.<ref name="MD">{{cite web|title=Asparaginase: Martindale: The Complete Drug Reference|date=June 2017|access-date=9 August 2017|url=https://www.medicinescomplete.com/mc/martindale/current/ms-1823-z.htm| veditors = Brayfield A |publisher= Pharmaceutical Press|website=MedicinesComplete|location=London, UK|archive-date=27 August 2021|archive-url=https://web.archive.org/web/20210827225546/https://about.medicinescomplete.com/wp-content/themes/mc-marketing/assets/images/favicons-tiles/favicon.ico|url-status=live}}</ref><ref name="js"/><ref name="BNF57"/> The United States Adopted Name of crisantaspase is asparaginase ''Erwinia chrysanthemi''.<ref name="MD"/> Elspar, Kidrolase, Leunase and Spectrila are brand names for colaspase, while Erwinase and Erwinaze are brand names for crisantaspase.<ref name="MD"/> Oncaspar is the brand name of pegaspargase.<ref name="MD"/>

== References == {{reflist}}

== External links == * {{ELM|CLV_TASPASE1}} * {{MeshName|Asparaginase}} * {{ClinicalTrialsGov|NCT04145531|An Open-Label Study of JZP-458 (RC-P) in Patients With Acute Lymphoblastic Leukemia (ALL)/Lymphoblastic Lymphoma (LBL)}}

{{Chemotherapeutic agents}} {{Amino acid metabolism enzymes}} {{Carbon-nitrogen non-peptide hydrolases}} {{Enzymes}} {{Portal bar|Medicine|Biology|border=no}} {{Authority control}}

Category:EC 3.5.1 Category:Antineoplastic drugs Category:Orphan drugs Category:World Health Organization essential medicines Category:Wikipedia medicine articles ready to translate

id:Asparaginase