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Abstract
Introduction: L-asparaginase had been studied as an alternative in the treatment of Acute Lymphoblastic Leukemia (ALL) because it has the ability to induce apoptosis in leukemic cells without causing damage to normal cells. Studies have shown benefits in the treatment of ALL, but with the risk of developing adverse effects. Objective: This work aims to present and explain the history of L-asparaginase, advantages, disadvantages, challenges faced by Brazil, in addition to the mechanisms of action involving the forms of the enzyme, and adverse effects of its use. Methods: Articles in portuguese and english were included in this work, consulted in article banks such as PubMed and SciELO, covering the period from 1953 to the present day in 2021. Results: L-asparaginase is an enzyme that breaks down asparagine into aspartate and ammonia, it was isolated from colonies of Escherichia coli and Erwinia chrysanthemi. In addition, the enzyme was polymerized with polyethylene glycol. The use of corticosteroids, antihistamines and vitamin supplementation proved to be effective in mitigating adverse effects. Conclusions: In this way, they are examined to avoid a shortage of L-asparaginase in Brazil, mainly due to the difficulty of marketing and high costs, even though being a drug present in the list of the World Health Organization as essential. Researchers are evaluating new treatment possibilities with L-asparaginase that are more viable in terms of cost and adverse effects.