Gut bacterial gene changes following pegaspargase treatment in pediatric patients with Acute Lymphoblastic Leukemia

Treatment of pediatric acute lymphoblastic leukemia (ALL) with pegaspargase exploits ALL cells dependency on asparagine. Pegaspargase depletes asparagine, consequentially affecting aspartate, glutamine and glutamate. The gut as a confounding source of these amino acids (AAs) and the role of gut microbiome metabolism of AAs has not been examined. Understanding how microbial gene-products, which interact with these AAs change over treatment were examined. Understanding pathways that change AA availability, including by microbes in the gut, could be useful in optimizing pegaspargase therapy.