nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.21682/2311-1267-2021-8-4-81-89nodgo-775Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSПрепараты аспарагиназы: новый взгляд на механизм действия, побочные эффекты и опыт использования в протоколах группы BFM (Berlin–Frankfurt–Munster)Asparaginase drugs: a new view of the mechanism of action, side effects and experience in BFM (Berlin–Frankfurt–Munster) protocolshttps://orcid.org/0000-0002-8482-1863КоркинаЮ. С.KorkinaY. S.

Ю.С. Коркина: аспирант кафедры детской онкологии им. акад. Л.А. Дурнова

125993, Москва, ул. Баррикадная, 2/1, стр. 1

Yu.S. Korkina: Resident of the Department of Pediatric Oncology named after Academician L.A. Durnov

125993, Moscow, Barrikadnaya St., Bld. 1, 2/1

juliaskomorokhova@mail.ruhttps://orcid.org/0000-0002-1469-2365ВалиевТ. Т.ValievT. T.

Т.Т. Валиев: д.м.н., заведующий отделением детской онкологии и гематологии (химиотерапия гемобластозов) № 1 НИИ детской онкологии и гематологии НМИЦ онкологии им. Н.Н. Блохина; профессор кафедры детской онкологии им. акад. Л.А. Дурнова РМАНПО

125993, Москва, ул. Баррикадная, 2/1, стр. 1115478, Москва, Каширское шоссе, 23

T.T. Valiev: Dr. of Sci. (Med.), Head of the Department of Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No. 1 of the Research Institute of Pediatric Oncology and Hematology at N.N. Blokhin National Medical Research Center of Oncology; Professor at the Department of Pediatric Oncology named after Academician L.A. Durnov at Russian Medical Academy of Continuing Professional Education

125993, Moscow, Barrikadnaya St., Bld. 1, 2/1115478, Moscow, Kashirskoe Shosse, 23

timurvaliev@mail.ruФГБОУ ДПО РМАНПО Минздрава РоссииРоссияRussian Medical Academy of Continuous Professional Education, Ministry of Health of RussiaRussian FederationФГБОУ ДПО РМАНПО Минздрава России; ФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияRussian Medical Academy of Continuous Professional Education, Ministry of Health of Russia; N.N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of RussiaRussian Federation202120012022848189Copyright © Коркина Ю.С., Валиев Т.Т., 20222022Коркина Ю.С., Валиев Т.Т.Korkina Y.S., Valiev T.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/775

Лекарственные препараты аспарагиназы являются неотъемлемой частью мультикомпонентных схем химиотерапии при остром лимфобластном лейкозе (ОЛЛ) у детей и взрослых. Несмотря на применение различных протоколов лечения ОЛЛ, набор препаратов одинаков, отличия касаются доз и кратности введения цитостатиков. Первым препаратом аспарагиназы, который стал использоваться в лечении ОЛЛ, была нативная L-аспарагиназа, полученная от Escherichia coli. По мере накопления опыта о нежелательных и побочных эффектах были созданы препараты аспарагиназы, обладающие менее выраженными побочными эффектами: пегилированная форма (ПЕГ-аспарагиназа), аспарагиназа, полученная от Erwinia сhrysanthemi (эрвиназа), и пегилированная форма эрвиназы (кризантаспаза). Настоящий обзор посвящен современным представлениям о механизмах действия различных препаратов аспарагиназы, фармакологических свойствах и неблагоприятных эффектах. Особое внимание в статье уделено вопросам разработки новых лекарственных форм аспарагиназы, которые помогут минимизировать побочные явления и повысить эффективность препарата. Не менее актуальный вопрос – лекарственный мониторинг аспарагиназы в крови, необходимый для своевременного выявления побочных эффектов и отслеживания эффективности проводимой терапии. Внедрение лекарственного мониторинга поможет индивидуализировать и повысить эффективность лечения ОЛЛ.

Asparaginase drugs are integrated to multicomponent chemotherapy protocols for acute lymphoblastic leukemia (ALL) in children and adults. Despite the use of different treatment protocols for ALL therapy, drugs are the same there and the differences include the doses and the frequency of administration of cytostatics. Native L-asparaginase obtained from Escherichia coli was the first asparaginase drug for the treatment of ALL. With accumulated knowledge about undesirable and side effects another asparaginase drugs with less expressed side effects were created: pegylated form (PEG-asparaginase), asparaginase derived from Erwinia chrysanthemi (erwinase) and pegylated form of erwinase (crisantaspase).This review is devoted to modern ideas about the mechanisms of action of various asparaginase drugs, pharmacological properties and adverse effects. There is a particular attention to the development of new forms of asparaginase, which will help minimize side effects and increase the effectiveness of the drug. Of no less importance is drug monitoring of asparaginase in the blood to detect side effect at the time and to understand the effectiveness of the therapy. The introduction of drug monitoring will help to individualize and improve the effectiveness of ALL treatment.

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The authors declare that there are no conflicts of interest present.