Crisantaspase (Specialist drug)

How it works

It depletes circulating asparagine by hydrolysing it to aspartic acid and ammonia; leukaemic cells cannot synthesise asparagine and are selectively starved of this amino acid, impairing protein synthesis and survival.

Prescribing in practice

• Hypersensitivity and anaphylaxis are major risks, so administration requires resuscitation facilities and close observation.
• Other important toxicities include coagulopathy (thrombosis or bleeding), pancreatitis and hyperglycaemia.
• A specialist agent given only within haemato-oncology protocols under expert supervision per the SPC.

Monitoring

Monitor for hypersensitivity reactions, coagulation parameters, blood glucose and for clinical signs of pancreatitis during therapy.

Counselling the patient

• Report any rash, breathlessness or swelling during or after the injection immediately.
• Report severe abdominal pain, which may indicate pancreatitis.
• Increased thirst or other symptoms of high blood sugar should be reported.

Evidence & guidelines

Its role is supported by the SPC and acute lymphoblastic leukaemia treatment protocols, where it serves as an alternative asparaginase preparation.