Acute pancreatitis following L-asparaginase in acute lymphoblastic leukemia

harzi, Soulaimane M; Elouali, Aziza; Lahrache, Karim; Ghanam, Ayad; Babakhouya, Abdeladim; Rkain, Maria; Benajiba, Noufissa

doi:10.1016/j.lrr.2022.100357

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…Однако считается, что си стемное истощение аспарагина, которое индуцирует гибель лейкемических клеток, приводит к гиперакти вации фермента аспарагинсинтетазы. В самом боль шом количестве в организме данный фермент на ходится в поджелудочной железе, так как высокая концентрация аспарагина необходима для синтеза белков панкреати ческих пищеварительных ферментов [6][7][8].…”

Section: Introductionunclassified

Successful treatment of pancreatitis caused by L-asparaginase in clinical practice

Korkina,

Shervashidze,

Valiev

et al. 2024

Onkogematologiâ

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Treatment intensification of acute lymphoblastic leukemia in children with L-asparaginase (L-ASP) improves therapy effectiveness and shows high survival rates. The unique biological properties of this enzyme make it possible to suppress tumor blasts proliferation by reducing blood asparagine concentration. L-ASP use is limited by toxicity and hypersensitivity reactions observed in 75 % of cases. Although most complications during L-ASP therapy are mild/moderate and are manageable with adequate accompanying therapy, the development of severe side effects leads to forced withdrawal of L-ASP, which significantly reduces the likelihood of a favorable outcome in children with acute lymphoblastic leukemia. One of the most severe toxicity manifestations is the development of asparaginase-associated pancreatitis. It worsens the prognosis and may cause patients’ death. This article presents both current data about asparaginase-associated pancreatitis and treatment experience of this complication at the Research Institute of Pediatric Oncology and Hematology of the N. N. Blokhin National Research Center of Oncology.

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Section: Introductionunclassified

Successful treatment of pancreatitis caused by L-asparaginase in clinical practice

Korkina,

Shervashidze,

Valiev

et al. 2024

Onkogematologiâ

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“…The objective of its administration is to reduce the concentration of Asparagine (Asp) in both plasma and cerebrospinal fluid (CSF), leaving therefore the tumor cells without basic nutrients, for protein synthesis and causing cell death [2]. Although L-Asp is a cornerstone of ALL treatment, it is commonly associated with adverse effects, including pancreatitis [3][4][5]. In severe cases, it requires discontinuation of L-Asp treatment, which secondarily increases the risk of relapse in ALL patients [6].…”

Section: Introductionmentioning

confidence: 99%

"Rapid Asparagine Depletion as a Possible Risk Marker for Pancreatitis in Children with Acute Lymphoblastic Leukemia Under Treatment with L-Asparaginase: Case Report from Five Patients"

Lares‐Asseff

2023

BJSTR

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We will be describing our experience with five patients diagnosed with acute lymphoblastic leukemia (ALL), who developed L-Asparaginase (L-Asp)-induced pancreatitis during their remission induction stage. The patients were treated, at the State Cancer Center of Durango, Mexico (CECAN-Durango) since December 2021, along with a group of 30 pediatric patients (in the remission induction phase of their treatment) who did not develop pancreatitis. All patients were diagnosed with (ALL) according to criteria from the French American-British Hematology Association (FAB). Once diagnosed, patients were treated according to the St. Jude Total XV protocol. In the protocol group, L-Asp enzyme activity and asparagine (Asp) concentrations were measured on 3 occasions. Population pharmacokinetic/pharmacodynamic (PK/PD) modeling using the previously assembled and validated monolix suite software was used to determine PK/PD parameters. Four of the patients after the ninth administration and one after the sixth administration of L-Asp revealed an increase in amylase and lipase enzymes even though the patients were asymptomatic. Three of the patients had abdominal distension and diffused pain. A computed axial tomography (CAT) scan confirmed the diagnosis of pancreatitis due to the use of L-Asp, which was immediately discontinued. Regarding Asp levels, it was observed that the five patients who developed pancreatitis reached complete depletion earlier than the 30 patients without pancreatitis. By analyzing the decay slope of Asp, we found that this could be a risk. marker for the development of pancreatitis as an adverse effect of the administration of L-Asp in patients with ALL.

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Asparaginase/dexamethasone

2023

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Acute pancreatitis following L-asparaginase in acute lymphoblastic leukemia

Cited by 5 publications

References 20 publications

Successful treatment of pancreatitis caused by L-asparaginase in clinical practice

Successful treatment of pancreatitis caused by L-asparaginase in clinical practice

"Rapid Asparagine Depletion as a Possible Risk Marker for Pancreatitis in Children with Acute Lymphoblastic Leukemia Under Treatment with L-Asparaginase: Case Report from Five Patients"

Asparaginase/dexamethasone

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