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Comment
. 2014 Aug 21;124(8):1206-7.
doi: 10.1182/blood-2014-07-585919.

Asparaginase allergies: it's all in the genes

Meir Wetzler  1
Affiliations
Comment

Asparaginase allergies: it's all in the genes

Meir Wetzler. Blood. .

Abstract

In this issue of Blood, Fernandez et al demonstrate that human leukocyte antigen (HLA) DRB1 alleles confer high-affinity binding to asparaginase epitopes, leading to higher frequency of allergic reactions. The authors initially examined HLA data from European ancestry patients enrolled onto St. Jude Children’s Research Hospital (n = 541) and the Children’s Oncology Group (n = 1329) clinical trials and identified a higher incidence of allergic reactions and anti-asparaginase antibodies in patients with HLA-DRB1*07:01 alleles. They then analyzed the structure of the HLA protein to show high-risk amino acids located within the binding pocket (see figure), possibly affecting the interaction between asparaginase epitopes and the HLA-DRB1 protein.

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Conflict of interest statement

Conflict-of-interest disclosure: The author served as consultant and received honoraria from Sigma-Tau and Jazz Pharmaceuticals.

Figures

None
Schematic representation of the interaction between HLA-DRB1 and asparaginase epitopes.
See this image and copyright information in PMC

Comment on

  • HLA-DRB1*07:01 is associated with a higher risk of asparaginase allergies.
    Fernandez CA, Smith C, Yang W, Daté M, Bashford D, Larsen E, Bowman WP, Liu C, Ramsey LB, Chang T, Turner V, Loh ML, Raetz EA, Winick NJ, Hunger SP, Carroll WL, Onengut-Gumuscu S, Chen WM, Concannon P, Rich SS, Scheet P, Jeha S, Pui CH, Evans WE, Devidas M, Relling MV. Fernandez CA, et al. Blood. 2014 Aug 21;124(8):1266-76. doi: 10.1182/blood-2014-03-563742. Epub 2014 Jun 26. Blood. 2014. PMID: 24970932 Free PMC article. Clinical Trial.

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