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Response to Asparaginase

Kusuma K. Reddy, MD; Geraldine P. Schechter, MD; Lawrence E. Pierce, MD

Arch Intern Med. 1981;141(1):113-115.

Abstract
A 69-year-old woman previously diagnosed as having chronic lymphocytic leukemia had a lymphocyte count of 1,500 x 10⁹/L develop. Bone marrow and peripheral blood lymphocyte morphology and lymphocyte surface markers were consistent with the diagnosis of prolymphocytic leukemia of the null cell type. The leukemia was resistant to management with alkylating agents, combination chemotherapy including doxorubicin hydrochloride, or leukapheresis. The addition of asparaginase to the previously ineffective prednisone and vincristine sulfate therapy produced a dramatic response during a two-week period with a decrease in the peripheral lymphocyte count from 980 x 10⁹ to 20 x 10⁹/L and a return toward normal of the concentration of polymorphonuclear leukocytes. Previously, there has been only infrequent or transient benefit from treatment provided these patients from regimens including chemotherapy, splenectomy, irradiation, and leukapheresis. It is suggested that asparaginase be considered as initial induction therapy for this disease process.

(Arch Intern Med 141:113-115, 1981)

Author Affiliations
From the Washington Hospital Center, Washington Veterans Administration Hospital, George Washington University, School of Medicine, Washington, DC.

Footnotes
Accepted for publication April 1, 1980.

Reprint requests to 110 Irving St NW, Washington, DC 20010 (Dr Pierce).

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