Asparlas
Asparlas (calaspargase pegol) is a chemotherapy medication used to treat children and young adults aged 1 month to 21 years with acute lymphoblastic leukemia (ALL). It’s typically given together with other chemotherapy medications. Compared to other asparaginase treatments, Asparlas (calaspargase pegol) stays in the body the longest. The medication is given as an injection into the vein (intravenous, IV), usually no more than every 3 weeks. Some side effects include pancreatitis, serious liver problems, and blood clots.
What is Asparlas (calaspargase pegol)?
What is Asparlas (calaspargase pegol) used for?
- Treatment of children and young adults aged 1 month to 21 years with acute lymphoblastic leukemia (ALL) given together with other chemotherapy medications
How Asparlas (calaspargase pegol) works
Asparlas (calaspargase pegol) is an asparagine specific enzyme. It works by targeting asparagine, a nutrient that cancer cells need to survive. By breaking down asparagine, Asparlas (calaspargase pegol) prevents cancer cells from using it, which helps stop them from growing and spreading.
Drug facts
Side effects of Asparlas (calaspargase pegol)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- High liver enzymes (52%)
- High bilirubin (20%)
- Pancreatitis (18%)
- Abnormal clotting labs (14%)
- Diarrhea (9%)
- Allergic reaction (8%)
- Blood clot (8%)
Note: Side effects shown above are from a study where Asparlas (calaspargase pegol) was given with other medications, so these side effects might not be solely due to Asparlas (calaspargase pegol).
Less Common Side Effects
- Sepsis
- Trouble breathing
- Bleeding
- Fungal infection
- Pneumonia
- Heart rhythm changes
Asparlas (calaspargase pegol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction: trouble breathing, hives, itching, facial swelling, dizziness, fainting
- Pancreatitis: severe stomach pain, fever, nausea, vomiting, chills, diarrhea
- Blood clots: sudden and severe headache, swelling in the arms or legs, trouble breathing, chest pain
- Severe liver problems: sudden weight gain, stomach pain or swelling, nausea, vomiting, yellowing of the skin or the whites of the eyes
The following Asparlas (calaspargase pegol) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Asparlas (calaspargase pegol)
Pros
- Recommended as part of combination therapy for ALL in children and young adults
- Works well for treating ALL, with 95% of people in studies achieving complete remission
- Typically only given once every 3 weeks
Cons
- Given as an intravenous injection, so it requires a needle
- Not FDA approved for adults older than 21 years with ALL
- Might cause serious side effects such as pancreas or liver problems
Pharmacist tips for Asparlas (calaspargase pegol)
- Because Asparlas (calaspargase pegol) can cause allergic reactions, you'll need to take premedications like acetaminophen (Tylenol), diphenhydramine (Benadryl), and famotidine (Pepcid) 30 to 60 minutes before each dose. If you experience symptoms like trouble breathing, lip or eye swelling, itchiness, or rash during or shortly after your treatment, tell your care team right away.
- Asparlas (calaspargase pegol) is usually given together with several other chemotherapy medications as part of a complex treatment regimen. The treatment schedule can be complicated and confusing. Consider using a treatment calendar or an app on your phone to help you keep track of appointments.
- Expect your Asparlas (calaspargase pegol) infusion to take at least 1 hour. But, since you'll also receive premedications and other chemotherapy drugs, plan for the entire treatment to take half a day or more.
- Asparlas (calaspargase pegol) can cause pancreatitis, or swelling of the pancreas. Seek medical help if you have symptoms such as severe stomach pain, fever, nausea and vomiting that won’t stop, and diarrhea.
- Asparlas (calaspargase pegol) can cause serious liver problems, so you’ll need to get regular labs done to check your liver health. If your liver enzymes are too high, you might need to pause. If you experience symptoms like yellow eyes, yellow skin, stomach pain, or a swollen belly, contact your care team right away.
- If you can become pregnant, use non-hormonal birth control while you’re taking Asparlas (calaspargase pegol). You’ll also need to continue to use birth control for at least 3 months after you stop treatment.
- It’s best to avoid breastfeeding while you’re taking Asparlas (calaspargase pegol) and for at least 3 months after your last dose, as there are potential risks to the baby.
Common questions about Asparlas (calaspargase pegol)
Yes, Asparlas (calaspargase pegol) is considered a chemotherapy medication. Because cancer cells grow faster than normal cells, most chemotherapies target cells that grow quickly. Asparlas (calaspargase pegol) breaks down a specific nutrient that cancer cells need to keep growing. Without that nutrient, cancer cells can’t grow as well.
Asparlas (calaspargase pegol) and Oncaspar (pegaspargase) are both similar long-lasting forms of asparaginase used to treat ALL. The key difference is how long they stay active in the body. While Oncaspar (pegaspargase) is given no more than every 2 weeks, Asparlas (calaspargase pegol) lasts longer and can be given every 3 weeks. Another difference is that Asparlas (calaspargase pegol) is only injected through a vein, but Oncaspar (pegaspargase) can be injected either through a vein or a muscle. Speak with your oncologist if you have questions about how they compare to each other.
Yes. Asparlas (calaspargase pegol) is derived from the bacteria E. coli. Some people have developed serious allergic reactions from asparaginase treatments that are made from E. coli. If you have concerns about your risk of allergic reactions, speak with your oncologist.
Asparlas (calaspargase pegol) was approved by the FDA in 2018 to treat ALL in children and young adults. Compared to similar asparaginase treatments, it stays in the body longer, allowing it to be given every 3 weeks.
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Risks and warnings for Asparlas (calaspargase pegol)
Asparlas (calaspargase pegol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Allergic reactions
People taking Asparlas (calaspargase pegol) can develop serious allergic reactions. These reactions can include rash, trouble breathing, facial swelling, hives, itching, or low blood pressure. To help prevent these reactions, you’ll take premedications such as acetaminophen (Tylenol), diphenhydramine (Benadryl), and famotidine (Pepcid) 30 to 60 minutes before each dose. You might have to stay in the clinic for an hour after your dose to make sure you don’t experience any reactions. If you have a serious reaction, you likely won’t be able to continue taking this medication
Pancreatitis
People taking Asparlas (calaspargase pegol) have developed pancreatitis, a condition where your pancreas becomes irritated and swollen. If not managed quickly, the pancreas can start bleeding and some pancreas cells can die, which can be life threatening. Contact your oncologist if you develop symptoms such as fever, nausea and vomiting, and severe stomach pain in the upper belly area. You might need to pause taking this medication while your oncologist looks into it. If they determine that you do have pancreatitis, you might need to stop taking Asparlas (calaspargase pegol) altogether.
Blood clots
Some people taking Asparlas (calaspargase pegol) have developed blood clots. If you have swelling, warm skin, or redness in one arm or one leg, trouble breathing, a sudden and severe headache, or weakness on one side of your body, get medical help right away.
Bleeding
Some people taking Asparlas (calaspargase pegol) have had lab tests showing problems with blood clotting. This means your body might have trouble stopping bleeding. If you experience bleeding that won’t stop or notice more bruising, let your care team know.
Liver problems
Asparlas (calaspargase pegol) can cause serious liver problems, some even life-threatening. Your oncologist will monitor your liver health on a regular basis to make sure this medication is still safe for you to take. If your liver labs are too high, you might need to pause or stop treatment. If you experience symptoms of liver problems such as stomach pain, sudden weight gain, yellowing of the skin, or yellowing around the whites of your eyes, call your oncologist right away.
Asparlas (calaspargase pegol) dosage
Typical dosage for Asparlas (calaspargase pegol)
Your provider will calculate your dose of Asparlas (calaspargase pegol) based on your body surface area (BSA), which takes into account your height and weight.
The typical dose is 2,500 units/m^2 given intravenously no more often than every 3 weeks.
Asparlas (calaspargase pegol) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Asparlas (calaspargase pegol) will not be safe for you to take.
- History of serious blood clot to L-asparaginase treatment
- History of pancreatitis to L-asparaginase treatment
- History of bleeding to L-asparaginase treatment
- Severe liver problems
