Acute Pancreatitis in Children With Acute Lymphoblastic Leukemia Treated With L-Asparaginase

Abstract

L-asp is an effective drug to treat ALL, the administration of L-asp requires the monitoring of pancreatic toxicity to detect AP and have treatment initiated as early as possible. Chronic complications after AP occur in almost one third of cases.

Risk Factors for Hyperglycemia During Chemotherapy for Acute Lymphoblastic Leukemia Among Taiwanese Children

“…None of the hyperglycemic patients had concurrent hyperlipidemia or pancreatitis, which is even rarer (6-8%) in incidence and may cause permanent DM. 22,23 Our findings would suggest that steroids are the main culprit leading to hyperglycemia by interacting with pubertal hormones, adiposity, and other medications used in the treatment. Meanwhile, leukemic cells themselves may also alter the metabolism of adipose cytokines and induce systemic inflammatory processes.…”

Pain in malignant hematology

“…Therapy-related visceral pains have been reported in association with acute pancreatitis. This complication has been reported in 7% of ALL patients treated with l-asparaginase [39]. Again, pain of colic origin has been reported in 50% of patients with pseudo-obstruction by vincristine; the incidence of this complication has been reported to be as high as 12% of pediatric and adult patients treated with this agent.…”

“…In addition, in the allogenic HSCT setting, intestinal involvement by GVHD represents another well-known source of visceral complaint. In addition, visceral pain may be observed in ALL patients with acute pancreatitis due to l-asparaginase [39] and in MM patients treated with bortezomib, inducing intestinal neuropathy and visceral dismotility [18]; again, some neurotoxic drugs, such as thalidomide and vincristine may induce painful constipation [40]. Lastly, painful urinary bladder irritation and hemorrhagic cystitis may be observed in allogeneic HSCT patients, mainly if conditioned with total body irradiation (TBI) and cyclophosphamide (CY)-containing regimens [38].…”

Relationship Between Modified CT Severity Index and Clinical Features of L-Asparaginase-Associated Pancreatitis in Pediatric Acute Lymphoblastic Leukemia

“…played an important role in increasing the survival rate of childhood ALL, it can cause various adverse effects, including hypersensitivity reactions, hypoproteinemia, abnormal liver function test results, acute pancreatitis (AP), hyperglycemia, hypertriglyceridemia, and thrombosis [2][3][4][5][6][7][8][9][10]. L-asp-associated pancreatitis (L-AP) occurs in 2.5% to 16% of the treated patients [4].…”

“…L-asp-associated pancreatitis (L-AP) occurs in 2.5% to 16% of the treated patients [4]. L-AP is usually diagnosed on the basis of clinical symptoms, laboratory test results, and radiologic findings.…”