L-aspraginase - palliation?

RE: L-aspraginase - palliation?

Virginia Campbell — Mon, 17 Oct 2022 11:41:28 GMT

I've used it once, for a dog with epitheliotropic lymphoma. It seemed to help, but he was was on pred as well so don't know how much extra it brought to the party. After a few months his skin lesions just really blew up again and he was euthed.

"Does it sting on injection?"

Yes, and it was a fairly stoic dog but he did flinch poor chap. Not horrendously but probably worse than sq Synulox or Cerenia or Alizin, not as bad as IM Buscopan.

No other SEs noted in my case.

RE: L-aspraginase - palliation?

Beats — Wed, 12 Oct 2022 20:01:33 GMT

I would expect to get a week (minimum) to a month (maximum) benefit - but that is pure conjecture on my part - to repeat: I have used 3 times, and all pre-COVID, I am certainly not an oracle on this.

I don't recall it stinging in my limited use in dogs - but I give plenty of stingy injections and I don't know I would recall it if it had.

Finally, I think (though I may be wrong - fact check elsewhere if important to your decision making) that at least one vet in the clinic has taken more than one dose from a bottle for the same patient in past in spite of being labelled single-use and found to be effective.in real life.

This is the info on stability from manufacturers: https://www.medicines.org.uk/emc/product/11946

RE: L-aspraginase - palliation?

Sara Ramsey — Wed, 12 Oct 2022 14:33:17 GMT

thank you these are really helpful.

does "short term" mean a few days response and then reduced effect with each dose?

also, does it sting on injection?

RE: L-aspraginase - palliation?

Andreas Ege — Wed, 12 Oct 2022 09:57:38 GMT

No personal experience, but going by 2 studies found on superficial search anaphylactic reactions seem rare:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712998/

https://onlinelibrary.wiley.com/doi/abs/10.1111/vco.12749

RE: L-aspraginase - palliation?

Beats — Wed, 12 Oct 2022 07:21:07 GMT

i've used 3 times - worked each time (eg spinal lymphoma needing to get size down quick, bone marrow lymphoma where low neutrophils made me nervous about other drugs, and one other case).

Other than cost, I really liked it.

I don't think anaphylaxis on first dose is a risk. I've used more than once on at least one of those cases wihtout a problem, but I understand that anaphylaxis is a real issue with repeat use. I would have thought in a patient on steroids with that is immunosuppressed would be at a lower risk than one that is healthy, but I'd probably pre-treat with antihistamine - 1mg/kg cetirizine in the morning most likely, but I use injectables also if needed generally (I think we have phenergan on shelf presently).

That's my limited experience - not sure relevant to yours or not. I think the cost may be more than the benefit for you - it's going to be pretty short-term I would have thought.