Division of Pediatric Hematology and Oncology, Dr. Behçet Uz Children's Hospital, İzmir, Turkey.
Dokuz Eylul University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care, Izmir, Turkey.
Clin Ther. 2020 Apr;42(4):e82-e86. doi: 10.1016/j.clinthera.2020.02.015. Epub 2020 Mar 14.
l-Asparaginase (l-Asp) is a critical component of chemotherapy for acute lymphoblastic leukemia (ALL). However, toxic effects associated with l-Asp, such as hepatic dysfunction, pancreatitis, hypercholesterolemia, and hyperglycemia, have occurred. In addition, acute pancreatitis is a significant life-threatening adverse event associated with ALL. We describe 2 patients with ALL who had l-Asp-associated pancreatitis (AAP), with one patient presenting with hyperglycemia and the other presenting with hypoglycemia during induction treatment. When octreotide was administered to both of these patients, the clinical findings and laboratory data were improved. AAP was not repeated after treatment with pegylated asparaginase. Although AAP has a high risk of mortality and morbidity in childhood, APP treatment with appropriate agents, such as octreotide, can be successful.
左旋门冬酰胺酶（l-Asp）是治疗急性淋巴细胞白血病（ALL）的化疗的关键组成部分。然而，与 l-Asp 相关的毒性作用，如肝肾功能障碍、胰腺炎、高胆固醇血症和高血糖症，已经发生。此外，急性胰腺炎是 ALL 相关的严重威胁生命的不良事件。我们描述了 2 例接受 l-Asp 相关胰腺炎（AAP）治疗的 ALL 患者，其中 1 例在诱导治疗期间出现高血糖，另 1 例出现低血糖。当给这 2 位患者使用奥曲肽时，临床发现和实验室数据得到了改善。使用聚乙二醇化门冬酰胺酶治疗后，AAP 未再发生。尽管 AAP 在儿童时期具有高死亡率和发病率的风险，但使用奥曲肽等适当的药物治疗 APP 可以获得成功。
