Crisantaspase (Erwinase) for the indications acute lymphatic leukaemia & lymphoblastic non-Hodgkin lymphoma

Asparaginase is an important part of treatment of ALL and lymphoblastic non-Hodgkin lymphoma. The use of asparaginase has been included in all national and international protocols for the treatment of these diseases. For patients with a proven clinical allergy or ‘silent inactivation’ for E. coli asparaginase and PEG-asparaginase, crisantaspase (Erwinia asparaginase) is the only option to continue treatment with asparaginase and to achieve levels of asparaginase that lead to complete asparagine depletion. Continued asparaginase treatment leads to an 10-15% increase in EFS in ALL in comparison to stopping E. coli (PEG)-asparaginase. For the treatment of patients with ALL and lymphoblastic non-Hodgkin lymphoma who are hypersensitive to (PEG)-asparaginase, crisantaspase (Erwinia asparaginase) has an added value in comparison to stopping with E. coli asparaginase.

This report is a summary of recommendations by Zorginstituut Nederland. The original text is in Dutch.