Zusammenfassung
88 Kranke mit malignen Neoplasien wurden mit dem ausE. coli hergestellten Enzym L-Asparaginase behandelt. Das therapeutische Ergebnis konnte bei 60 Kranken ausgewertet werden. Bei 20 von 33 Kranken mit akuter Lymphoblastenleukämie, bei 1 Kranken mit Lymphosarkom in leukämischer Phase und bei 1 von 5 Kranken mit akuter Myeloblasten- oder Myelomonocytenleukämie wurde eine Knochenmarksremission erzielt. Die Remissionsdauer betrug 1–8 Monate. Von 21 Kranken mit malignen Lymphomen, Sarkomen und Carcinomen sprach nur 1 Patient mit malignem Melanom auf die Behandlung mit Asparaginase an. Die Enzympräparation bewirkte in der bisher angewandten Dosis keine Knochenmarkshemmung. Reversible Nebenwirkungen waren gekennzeichnet durch Fieber, Gewichtsverlust, abnorme Leberfunktionsproben, Hypoalbuminämie, Hypofibrinogenämie, Hypolipidämie, Hyperlipidämie und Überempfindlichkeitsreaktionen gegenüber der Enzympräparation. Die Asparaginabhängigkeit der neoplastischen Zellen ließ sich auchin vitro nachweisen. Dieser Test erlaubt jedoch noch keine absolut sichere Vorhersage des Behandlungsergebnisses. Wenn sich während der Behandlung einer primär asparaginase-empfindlichen Leukämie Resistenz entwickelte, waren die Leukämiezellen auchin vitro nicht mehr asparaginabhängig.
Summary
Eighty-eight patients with malignant diseases were treated with L-asparaginase prepared fromE. coli. The therapeutic result could be evaluated in 60 patients. A bone marrow remission was obtained in 20 of 33 patients with acute lymphoblastic leukemia, in one patient with lymphosarcoma in leukemic phase, and in one of five patients with acute myelo- or myelo-monoblastic leukemia. The remissions lasted from 1 to 8 months. Of 21 patients with malignant lymphomas, sarcomas or carcinomas only one patient with malignant melanoma responded to treatment with asparaginase. The enzyme preparation, at the dose levels used, did not cause bone marrow depression. Reversible side effects were fever, weight loss, abnormal liver function tests, hypoalbuminemia, hypofibrinogenemia, hypolipidemia, hyperlipidemia, and hypersensitivity reactions. The dependence on L-asparaginase of the neoplastic cells could also be demonstratedin vitro. This test, however, does not yet make possible an absolutely safe prediction of the therapeutic result. When resistance developed during the treatment of a primarily asparaginase-sensitive leukemia, the leukemia cells no longer required asparaginein vitro.
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Visiting Research Fellow, beurlaubt von der Medizinischen Klinik der Universität Köln.
Mit Unterstützung des National Cancer Institute, Grants CA 08748 und CA 05826.
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Oettgen, H.F., Schulten, H.K. Hemmung maligner Neoplasien des Menschen durch L-Asparaginase. Klin Wochenschr 47, 65–71 (1969). https://doi.org/10.1007/BF01745767
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DOI: https://doi.org/10.1007/BF01745767