Servier Canada
Asparlas®
ASPARLAS logo; ASPARLAS calaspargase pegol for injection

Therapeutic drug monitoring1

Measurement of the L-asparaginase activity level in serum or plasma may be undertaken in order to rule out an accelerated reduction of L-asparaginase activity.

The decrease in the number of circulating lymphoblasts is often quite marked, and normal or too low leukocyte counts are often seen in the first days after the start of therapy. To monitor the therapeutic effect, the peripheral blood count and the patient’s bone marrow should be monitored closely.

Low L-asparaginase activity levels are often accompanied by the appearance of anti-L-asparaginase antibodies. In such cases, a switch to a different L-asparaginase preparation should be considered.

Please consult the ASPARLAS® Product Monograph for full recommendations on TDM.

Learn more about ASPARLAS®

aBFM: augmented Berlin-Frankfurt-Münster; AE: adverse event; ALL: acute lymphoblastic leukemia; ALP: alkaline phosphatase; ALT: alanine aminotransferase; aPTT: activated partial thromboplastin time; AST: aspartate aminotransferase; BFM: Berlin-Frankfurt-Munster; BSA: body surface area; CSF: cerebrospinal fluid; CTCAE: Common Terminology Criteria for Adverse Events; DFCI: Dana-Farber Cancer Institute; IM: intramuscular; IV: intravenous; NCCN: National Comprehensive Cancer Network®; NPAA: nadir plasma arparaginase activity; NSAA: nadir serum asparaginase activity; NSAID: non-steroidal anti-inflammatory drug; PD: pharmacodynamics; PK: pharmacokinetics; TDM: therapeutic drug monitoring.

* Comparative clinical significance has not been established.

† Fictitious cases. May not be representative of all patients.

‡ Clinical significance has not been established.

References: 

  1. ASPARLAS® Product Monograph. Servier Canada.
  2. Data on file. Servier Canada.
  3. ONCASPAR® Product Monograph. Servier Canada.
  4. RYLAZE™ Product Monograph. Jazz Pharmaceuticals Canada Inc.
  5. Government of Canada. Summary Basis of Decision for Asparlas. Available at https://dhpp.hpfb-dgpsa.ca/review-documents/resource/SBD1718207489396.
  6. Government of Canada. ONCASPAR_CPID Redacted.
  7. Terwilliger T, Abdul-Hay M. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J. 2017;7(6):e577.
  8. Mank V, Azhar W, Brown K. Leukocytosis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; April 21, 2024.
  9. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Acute Lymphoblastic Leukemia, version 4.2023 – February 05, 2024.
  10. Vrooman LM et al. Efficacy and toxicity of pegaspargase and calaspargase pegol in childhood acute lymphoblastic leukemia: Results of DFCI 11-001. J Clin Oncol. 2021;39(31):3496–3505.
  11. National Institutes of Health. National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE): Version 4.0. Available at: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/Archive/CTCAE_4.0_2009-05-29_QuickReference_8.5×11.pdf. Accessed December 11, 2024.
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