Cremer P, Lakomek M, Beck W, Prindull G
Abteilungen Für Klinische Chemie, Universität Göttingen, Federal Republic of Germany.
Eur J Pediatr. 1988 Jan;147(1):64-7. doi: 10.1007/BF00442614.
L-asparaginase is an effective antileukaemic drug and a potent inhibitor of hepatic protein synthesis. Its effect on lipid metabolism was studied in two cohorts of children with ALL, one of whom received L-asparaginase concomitantly with three other drugs (protocol BFM 79). In the second protocol (BFM 83) administration of L-asparaginase was arranged to follow the other three drugs in time sequence. The two major findings of this study were elevated serum levels of total cholesterol and a strong increase in serum triglycerides. The former change was due to an increase in alpha-cholesterol and could not be attributed to L-asparaginase because it was also found following protocol BFM 83 before the administration of the drug. Elevations of total triglycerides were due to high levels of exogenous chylomicron bound triglycerides and were limited in occurrence almost exclusively to the period of L-asparaginase monotherapy. Hypothyroidism was excluded as a possible pathogenetic mechanism. These changes in lipid metabolism induced by L-asparaginase during intensive remission induction chemotherapy are fully reversible.
L-天冬酰胺酶是一种有效的抗白血病药物，也是肝脏蛋白质合成的强力抑制剂。在两组急性淋巴细胞白血病患儿中研究了其对脂质代谢的影响，其中一组患儿将L-天冬酰胺酶与其他三种药物同时使用（方案BFM 79）。在第二个方案（BFM 83）中，L-天冬酰胺酶的给药安排在时间顺序上紧随其他三种药物之后。该研究的两个主要发现是血清总胆固醇水平升高以及血清甘油三酯大幅增加。前一种变化是由于α-胆固醇增加所致，且不能归因于L-天冬酰胺酶，因为在方案BFM 83中，在给药前也发现了这种情况。总甘油三酯升高是由于外源性乳糜微粒结合甘油三酯水平较高，且几乎仅在L-天冬酰胺酶单一疗法期间出现。排除了甲状腺功能减退作为可能的致病机制。在强化缓解诱导化疗期间，L-天冬酰胺酶引起的这些脂质代谢变化是完全可逆的。
