Leukemias, lymphomas, and other hematologic cancers:
Indications for: ONCASPAR
First-line acute lymphoblastic leukemia (including patients with asparaginase hypersensitivity), as part of a multi-agent chemotherapy regimen.
Adults and Children:
Premedicate with APAP, diphenhydramine, and famotidine 30–60mins prior to initiation. Give by IV inj over 1–2hrs or by IM inj (max 2mL/inj site). Treat every 14 days. ≤21yrs: 2500 IU/m2. >21yrs: 2000 IU/m2. Dose modifications: see full labeling.
History of pancreatitis, serious hemorrhage, or thrombosis with prior L-asparaginase therapy. Severe hepatic impairment.
Observe patients for 1hr post-dose. Have medical treatment for anaphylaxis readily available. Permanently discontinue for Grade 3/4 infusion/hypersensitivity reactions, confirmed pancreatitis, or severe thrombosis. Monitor bilirubin and transaminases at least weekly during treatment cycles through at least 6wks after last dose. Monitor serum glucose, coagulation parameters. Discontinue if severe hemorrhage or liver toxicity occurs. Advise females of reproductive potential to use effective non-hormonal contraception during and for 3months after the last dose. Pregnancy: exclude status prior to initiation. Nursing mothers: not recommended (during and for 1month after last dose).
May increase the risk of glucocorticoid-induced toxicities.
Hypoalbuminemia, elevated transaminases/bilirubin, febrile neutropenia, hypertriglyceridemia, hyperglycemia, pancreatitis, coagulopathy, embolic/thrombotic events, hypersensitivity.
Generic Drug Availability:
Single-dose vial (5mL)—1