Prophylactic use of octreotide for asparaginase-induced acute pancreatitis

Sakaguchi, Sachi; Higa, Takeshi; Suzuki, Mitsuyoshi; Fujimura, Junya; Shimizu, Toshiaki

doi:10.1007/s12185-017-2219-z

Cited by 12 publications

(6 citation statements)

References 8 publications

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“…Octreotide prophylaxis was proposed to prevent AAP, but data showing efficacy of prophylaxis are limited. 86 If AAP occurs, patients benefit from early diagnosis and aggressive supportive measures, including hydration, pain control, parenteral feeding, and antimicrobial coverage. In severe cases, patients may require surgical intervention.…”

Section: Case 5: Pegasparaginase-induced Pancreatitismentioning

confidence: 99%

How I Treat the Toxicities of Pegasparaginase in Adults with Acute Lymphoblastic Leukemia

Aldoss

Douer

2020

Blood

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Administering asparaginase has always been problematic in adults since most general oncologists who treat adults are not familiar with its usage and toxicity. The toxicity profile of the drug is unique and not observed with any other chemotherapy agent. Furthermore, asparaginase is almost exclusively used in acute lymphoblastic leukemia (ALL) which is a very rare cancer in adults. Currently, the long acting pegylated form (pegasparaginase) is the only E. coli-derived asparaginase available in the US. The utilization of pediatric regimens is likely to lead to more adult patients receiving multiple doses of pegasparaginase. However, oncologists who treat adults may still be reluctant to use pegasparaginase or may unnecessarily discontinue its administration because of certain adverse effects. As a result, the clinical benefit of multiple doses of pegasparaginase will be missed. Despite the fact that pegasparaginase is associated with unique toxicities, the majority are non-fatal, manageable and reversible. Here, we describe real life cases of adults with ALL who were treated with pediatric-inspired regimens incorporating pegasparaginase to illustrate the management of several pegasparaginase-associated adverse effects and guide if and how to continue the drug.

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Section: Case 5: Pegasparaginase-induced Pancreatitismentioning

confidence: 99%

How I Treat the Toxicities of Pegasparaginase in Adults with Acute Lymphoblastic Leukemia

Aldoss

Douer

2020

Blood

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“…The primary agent being explored for AAP prophylaxis is octreotide, with early data suggesting that treatment with octreotide in children experiencing AAP resulted in clinical improvement (41). A retrospective systematic review by Sakaguchi et al using patient data from their center as well as previously published case reports found that the rate of secondary AAP in patients who received octreotide prophylaxis upon asparagine rechallenge was 36% (4/11 patients), which is nearly 10% lower than the established rechallenge AAP rate of 45% (42). However, the small sample size and methods of the review highlight the need for larger, more systematic studies to be conducted exploring octreotide use.…”

Section: Discussionmentioning

confidence: 99%

Case report: Hyperosmolar hyperglycemic syndrome secondary to PEG-asparaginase-induced hypertriglyceridemia and pancreatitis

et al. 2023

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Pegylated (PEG)-asparaginase is an established treatment for acute lymphoblastic leukemias that exhibits an antitumor effect by depleting asparagine, an amino acid essential for leukemia cell protein synthesis. Pancreatitis with hypertriglyceridemia is a well-established toxidrome associated with PEG-asparaginase. However, impaired pancreatic synthetic function and hormone release have rarely been reported as a result of PEG-asparaginase pancreatitis. In this report, we present a 22-year-old woman recently diagnosed with T-acute lymphoblastic leukemia (T-ALL), who presented to the hospital with progressive weakness, confusion, blurry vision, hallucinations, and abdominal pain after induction treatment with daunorubicin, vincristine, PEG-asparaginase, and dexamethasone following the AYA protocol. She was found to have hypertriglyceridemia, acute pancreatitis, and hyperosmolar hyperglycemic syndrome. While pancreatitis and hypertriglyceridemia are commonly reported side effects of PEG-asparaginase, HHS related to these conditions has been sparsely reported. Providers should maintain awareness of this association and consider routine serial glucose monitoring of patients receiving PEG-asparaginase.

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“…Los datos apoyan el uso de octreótido en pacientes que requieran continuar con L-ASA, ya que podrían beneficiarse. 14,15 En el caso presentado no se utilizó octreótido en el paciente, y recibió L-ASA posteriormente como parte del protocolo, sin llegar a manifestar complicaciones.…”

Section: Discussionunclassified

Pancreatitis aguda como efecto adverso de L-asparginasa en el tratamiento de la leucemia linfocítica aguda

Cohen-Rosenstock

Valverde-Muñoz

2020

AMC

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La leucemia linfocítica aguda es la enfermedad oncológica con mayor incidencia en la población pediátrica, tanto a nivel mundial como en Costa Rica. Para su tratamiento requiere protocolos de quimioterapia complejos, lo que representa un reto constante para los médicos, ya que deben equilibrar los riesgos y beneficios del manejo. Es necesario tomar en cuenta los factores de riesgo de cada paciente, el grado de severidad de la enfermedad y los potenciales efectos adversos del tratamiento. A continuación, se reporta un caso de pancreatitis aguda edematosa no biliar, secundaria al uso de L-asparginasa, en un paciente con diagnóstico de leucemia linfocítica aguda, atendido en el Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”. El paciente, quien se encontraba cumpliendo el régimen poliquimioterapeútico AHOPCA 2008, presentó clínica sugestiva de pancreatitis aguda en el día 50 de este, por lo que se decidió no colocar la quimioterapia indicada e inmediatamente se trasladó al Servicio de Emergencias. El cuadro clínico estaba asociado a laboratorios y ultrasonido anormales, por lo que fue tratado interdisciplinariamente y su pronóstico fue favorable; actualmente continúa con tratamiendo quimioterapeútico, como fue indicado.

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Prophylactic use of octreotide for asparaginase-induced acute pancreatitis

Cited by 12 publications

References 8 publications

How I Treat the Toxicities of Pegasparaginase in Adults with Acute Lymphoblastic Leukemia

How I Treat the Toxicities of Pegasparaginase in Adults with Acute Lymphoblastic Leukemia

Case report: Hyperosmolar hyperglycemic syndrome secondary to PEG-asparaginase-induced hypertriglyceridemia and pancreatitis

Pancreatitis aguda como efecto adverso de L-asparginasa en el tratamiento de la leucemia linfocítica aguda

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