Objective      To evaluate the efficacy and safety of L-asparaginase (L-Asp) and polyethylene glycol conjugated asparaginase (PEG-Asp) in VDLP regimen (vincristine，daunorubicin，L-asparaginase or PEG-asparaginase

prednisone) for induction treatment for adult acute lymphoblastic leukemia (ALL).       Methods      Clinical data of 121 patients with newly diagnosed adult ALL admitted in our department from January 2008 to March 2015 were collected and retrospectively analyzed. They were all treated with VDLP induction regimen

and 46 of them were in the PEG-Asp group and 75 in L-Asp group. Their complete remission (CR) rate

incidence of central nervous system leukemia (CNSL)

median relapse free survival (RFS) time

median overall survival (OS) time and asparaginase related side effects were compared between the 2 asparaginase groups.       Results      There were no significant differences between the PEG-Asp group and the L-Asp group in CR rate (93.18% vs 93.33%)

median RFS (306 vs 218 d) and median OS (422 vs 495 d

P0.05)

but the incidence of CNSL was obviously lower in the former than the latter group (11.36% vs 29.33%

Chi square=5.11，P=0.024). In term of the side effects，there were prolonged durations of coagulation dysfunction（9.13±5.22 vs 7.02±4.02 d

t=2.12，P=0.037）and agranulocytosis （19.26±9.41 vs 11.89±8.35 d

t=4.19，P0.01）in the PEG-Asp group than the other group. Meanwhile

the rate of severe infection (grade Ⅳ~Ⅴ) was remarkably higher in the PEG-Asp group (26.83% vs 5.71%

Chi square=9.86，P=0.002）. But there were no statistical differences in the incidences of bleeding event or infection-related mortality （P0.05）.       Conclusion      Though PEG-Asp has similar CR rate and long-term efficacy as L-Asp in the VDLP regimen for adult ALL

it causes lower incidence of CNSL

and longer durations of agranulocytosis and coagulation dysfunction and higher rate of severe infection. However

it doesn’t lead to higher incidences of bleeding event and infection-related mortality when in combination chemotherapy. So

PEG-Asp can be a front-line chemotherapeutic agent for adult ALL treatment.