Clinical course and outcome in children with acute lymphoblastic leukemia and asparaginase‐associated pancreatitis

Kearney, Susan; Dahlberg, Suzanne E.; Levy, Donna E.; Voss, Stephan D.; Sallan, Stephen E.; Silverman, Lewis B.

doi:10.1002/pbc.22076

Cited by 147 publications

(178 citation statements)

References 27 publications

(29 reference statements)

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“…Kearney et al, reported 39% of children with clinical and chemical pancreatitis did not have abnormalities detected by ultrasound; therefore, the diagnosis should not be dependent on radiographic confirmation. There was a high concordance between ultrasound and CT in detecting abnormalities, and so it may be reasonable to reserve the use of CT for those patients with persistence or worsening of clinical symptoms or laboratory findings in the setting of non-diagnostic ultrasonography [8]. While ultrasound findings were compatible with acute pancreatitis, abdominal CT (on the third day of admission) in our patient was normal.…”

Section: To the Editormentioning

confidence: 72%

Pancreatitis in a child with acute lymphoblastic leukemia after Erwinia asparaginase: Evaluation of ultrasonography and computerized tomography as diagnostic tools

Azık¹,

Kılıç²

2010

Turk J Hematol

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Acute pancreatitisis is a well described complication of L-asparaginase therapy [1,3]. Complications include hemorrhage, pseudocyst formation, pancreatic insufficiency, sepsis, and respiratory distress due to pulmonary edema or pleural effusion [2,5]. An 8 year old boy with ALL, who was on St. Jude Total XIII-high risk continuation therapy, tolerated E-coli asparaginase treatments well until he developed anaphylaxis reaction during E-coli asparaginase administration at 8 th week of continuation therapy. According to protocol the next L-asparaginase treatment was four weeks later. We switched E-coli asparaginase to Erwinia asparaginase, and he received vincristine, and prednisone at the 12 th week of continuation treatment. One week after first Erwinia asparaginase administration the patient was admitted to hospital with vomiting, diffuse abdominal pain and decreased oral intake. Physical examination revealed a pale, ill appearing child in acute distress with a diffuse sensitivity of upper abdomen but no rebound tenderness or guarding. Laboratory findings showed an amylase level of 477 mg/dl (normal <125 mg/dl), pancreatic lipase 292 U/L (0-60 U/L), pancreatic amylase 81 U/L (17-115 U/L). The most possible diagnosis was drug induced pancreatitis. Repeated laboratory evaluation showed a gradual increase in the serum amylase to 775 mg/dl by hospital day two. On the second day of admission, ultrasonography of the abdomen showed the pancreas was diffusely enlarged and heteroechogen. Although hypoechoic texture is expected in pancreatitis, ultrasonographic evaluation was heteroechogen in our patient. On the third day of admission abdominal computed tomography (CT) study was done to explain heteroechogenity in ultrasonography. Computed tomography scanning with intravenous contrast

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Section: To the Editormentioning

confidence: 72%

Pancreatitis in a child with acute lymphoblastic leukemia after Erwinia asparaginase: Evaluation of ultrasonography and computerized tomography as diagnostic tools

Azık¹,

Kılıç²

2010

Turk J Hematol

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“…This disease affects mainly children. Patients from 10 to 18 years old have an increased risk of 2.4 times to develop AAP, comparing with patients with less than 10 years old 1 . There are no studies comparing the risk among children and adults.…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…There is no relationship of dose or duration in treatment for pancreatitis, it usually appears after the fourth or sixth application. However there are reports of AAP on the first application 1,2,12,16,17 . Symptoms begin about 4 days after application, but may vary from 1 to 13 days 1,12,16 .…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…It can be caused by gallstones, metabolic disorders, associated or not with alcohol abuse, or medication. 1,2 The clinical diagnosis of acute pancreatitis is based on characteristic abdominal pain and nausea, combined with elevated serum levels of pancreatic enzymes (amylase and lipase) and abdominal imaging by computed tomography (CT), magnetic resonance imaging, or transabdominal ultrasonography. 2 L-asparaginase is a strategic medicine for the cure of acute lymphoblastic leukemia (ALL) in adults, increasing overall survival.…”

Section: Intr Intr Intr Intr Introduction Oduction Oduction Oductionmentioning

confidence: 99%

“…There is also the risk of developing chronic sequelae, such as prolonged pancreatic exocrine insufficiency. 1,[5][6][7][8] Case r Case r Case r Case r Case re e e e epor por por por port t t t t…”

Section: Intr Intr Intr Intr Introduction Oduction Oduction Oductionmentioning

confidence: 99%

See 2 more Smart Citations

Pancreatitis in adult with acute lymphoblastic leukemia using L-asparaginase and simvastatin: case report and systematic review

Rodrigues

Gavarrete

Bernardi

et al. 2016

Medicina (Ribeirão Preto)

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Context: Acute pancreatitis is a inflammatory process of the pancreas. It can be caused by gallstones, metabolic disorders, associated or not with alcohol abuse, or medication. Case Report: A 38-year-old man was admitted to the hospital because of worsening of nausea, abdominal pain, dizziness and white stool. Patient was diagnosed with severe acute pancreatitis. After six days of hospitalization, patient progressed into hypotension and severe bradycardia, and died. The patient used simvastatin chronically, and was in treat with L-asparaginase, both drugs related to the occurence of acute pancreatitis separately. Naranjo´s probability scale of adverse drug reaction established the causality between these medications and acute pancreatitis as probable. However, due to the absence of reports of causality, the RESUMOContexto: Pancreatite aguda é um processo inflamatório do pâncreas. É causada por cálculos biliares, desordens metabólicas, associadas ou não ao uso abusivo de álcool, ou medicamentos. Relato do Caso: Homem de 38 anos foi admitido no hospital em razão do agravamento de náuseas, dor abdominal, tontura e fezes brancas. O paciente foi diagnosticado com pancreatite aguda. Após seis dias de

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Acute pancreatitis as a complication of childhood cancer treatment

et al. 2016

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Acute pancreatitis (AP) is now well recognized as a possible complication of childhood cancer treatment, interrupting the chemotherapy regimen, and requiring prolonged hospitalization, possibly with intensive care and surgical intervention, thereby compromising the effect of chemotherapy and the remission of the underlying malignant disease. This review summarizes the current literature and presents the various etiological factors for AP during chemotherapy as well as modern trends in the diagnosis and therapy of AP in children.

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Clinical course and outcome in children with acute lymphoblastic leukemia and asparaginase‐associated pancreatitis

Abstract: Background-Asparaginase, an agent used in the treatment of acute lymphoblastic leukemia (ALL), is associated with the development of pancreatitis. The clinical course and long-term outcome of patients experiencing this complication has not been extensively detailed.

Cited by 147 publications

References 27 publications

Pancreatitis in a child with acute lymphoblastic leukemia after Erwinia asparaginase: Evaluation of ultrasonography and computerized tomography as diagnostic tools

Pancreatitis in a child with acute lymphoblastic leukemia after Erwinia asparaginase: Evaluation of ultrasonography and computerized tomography as diagnostic tools

Pancreatitis in adult with acute lymphoblastic leukemia using L-asparaginase and simvastatin: case report and systematic review

Acute pancreatitis as a complication of childhood cancer treatment

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