Lawson Eileen B, Gottschalk Michael, Schiff Deborah E
UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, San Diego, CA, USA.
J Pediatr Hematol Oncol. 2011 Mar;33(2):e83-6. doi: 10.1097/MPH.0b013e3181f46c22.
We describe a pediatric patient with acute leukemia who developed an uncommon but significant metabolic consequence of pegaspargase therapy-severe hypertriglyceridemia (hyperTG). We also relate our experience with continuous insulin infusion treatment for pegaspargase-induced hyperTG. This treatment approach led to a decrease in triglycerides from 4640 mg/dL on admission to 522 mg/dL at discharge 9 days later. Genetic testing revealed that our patient was an apolipoprotein E 3/4 heterozygote. Our review of the literature suggests that apolipoprotein E polymorphism may influence the development of hyperlipidemia in acute lymphoblastic leukemia patients receiving asparaginase therapy and may identify patients at high risk for developing asparaginase-induced hyperTG.
我们描述了一名患有急性白血病的儿科患者，其出现了聚乙二醇天冬酰胺酶治疗罕见但严重的代谢后果——严重高甘油三酯血症（高TG）。我们还分享了我们使用持续胰岛素输注治疗聚乙二醇天冬酰胺酶诱导的高TG的经验。这种治疗方法使甘油三酯水平从入院时的4640mg/dL降至9天后出院时的522mg/dL。基因检测显示我们的患者是载脂蛋白E 3/4杂合子。我们对文献的回顾表明，载脂蛋白E多态性可能影响接受天冬酰胺酶治疗的急性淋巴细胞白血病患者高脂血症的发生，并可能识别出发生天冬酰胺酶诱导的高TG的高危患者。
