Asparaginase contains the enzyme L-asparagine amidohydrolase which hydrolyses serum asparagine to nonfunctional aspartic acid and ammonia, depriving tumour cells of a required amino acid.

Indications: Acute lymphoblastic leukaemias (induction regimen in paediatric).

Cautions: Intradermal skin test should be performed prior to initial administration of this drug and repeated when at least 1 week separates doses (to avoid risk of anaphylaxis); monitor frequently serum amylase to detect early evidence of pancreatitis. If pancreatitis occurs, discontinue therapy.

Contra-indications: Anaphylactic reactions to asparaginase; pancreatitis or a history of pancreatitis; pregnancy & breast feeding.

Side Effects: anaphylaxis, nausea, vomiting, pancreatitis, CNS depression, and liver and blood lipid changes.

Careful monitoring is, therefore, necessary and the urine should be tested for glucose because of a risk of hyperglycaemia.