Asparaginase activity monitoring experience from the Maritimes, Canada

Investigating the gut microbial community and genes in children with differing levels of change in serum asparaginase activity during pegaspargase treatment for acute lymphoblastic leukemia

Asparaginase (ASNase) is an effective treatment of pediatric acute lymphoblastic leukemia (ALL). Changes in ASNase activity may lead to suboptimal treatment and poorer outcomes. The gut microbiome produces metabolites that could impact ASNase therapy, however, remains uninvestigated. We examined gut-microbial community and microbial-ASNase and asparagine synthetase (ASNS) genes using 16SrRNA and metagenomic sequence data from stool samples of pediatric ALL patients. Comparing ASNase activity between consecutive ASNase-doses, we found microbial communities differed between decreased- and increased-activity samples. Escherichia predominated in the decreased-activity community while Bacteroides and Streptococcus predominated in the increased-activity community. In addition microbial ASNS was significantly (p=.004) negatively correlated with change in serum ASNase activity. These preliminary findings suggest microbial communities prior to treatment could affect serum ASNase levels, although the mechanism is unknown. Replication in an independent cohort is needed, and future research on manipulation of these communities and genes could prove useful in optimizing ASNase therapy.

Clinical decisions following implementation of asparaginase activity monitoring in pediatric patients with acute lymphoblastic leukemia: Experience from a single-center study

We undertook this retrospective study to describe decisions made following asparaginase activity monitoring implementation at our center. Clinically apparent reactions (CARs) and asparaginase activity monitoring costs were described. Patients with acute lymphoblastic leukemia, aged <18 years who received asparaginase between April 2016 and September 2017, were included. Decisions made following receipt of asparaginase activity results were categorized as continuation, modification, premedication, or discontinuation. We included 129 patients (median age: 5.33 years) receiving 565 asparaginase doses. CARs were observed following 25 asparaginase doses (19/361 [5.3%] pegaspargase). A total of 224 asparaginase activity levels were ordered in 88 patients. Following receipt of 190 asparaginase activity results, asparaginase therapy was continued, modified, or premedicated in 188 (98.9%), 1 (0.005%), and 1 (0.005%) cases, respectively. Inadequate asparaginase activity was observed in three patients receiving Erwinia asparaginase. Asparaginase activity monitoring allowed patients with pegaspargase-associated CAR and adequate activity to continue therapy unchanged and was cost neutral.

L-asparaginase produced from soil isolates of Pseudomonas aeruginosa shows potent anti-cancer activity on HeLa cells

Among cancers, acute lymphoblastic leukemia (ALL) occurs in the children <15 years of age. L-asparaginase is an important therapeutic enzyme used for treating ALL. Owing to its therapeutic use and demand, microorganisms have been in use for many years to produce L-asparaginase on an industrial scale. Gram-negative bacteria (Serratia, Erwinia and Escherichia coli) species were used in L-asparaginase. However, earlier studies have documented that the long-term use of enzymes produced from these commercial strains induces hypersensitivity in patients. Therefore, there is a need to discover novel microbial strains producing L-asparaginase with anti-cancer properties, which can be employed for the commercial production of the enzyme. In this study, three strains of Pseudomonas aeruginosa (accession numbers LC425424 (P31), LC425425 (P32), and LC425426 (P34)) isolated from garden soil were screened for the invention of L-asparaginase. Fermented production media was dialyzed to attain the purified enzyme, thus showed a dose-depended cytotoxic effect on HeLa cells, as determined by MTT assay. The IC₅₀s of the different isolates were 86.73, 57.65, and 40.34 µg/mL. These results indicate that pseudomonal L-asparaginase may be used for cancer treatment.