左旋肉碱和维生素B输注成功治疗L-天冬酰胺酶诱导的肝毒性

Lee Christina, Leventhal Thomas M, Anugwom Chimaobi M

Internal Medicine, University of Minnesota Medical School, Minneapolis, USA.

Division of Gastroenterology, Hepatology, and Nutrition/Transplant Hepatology and Critical Care Medicine, University of Minnesota, Minneapolis, USA.

Cureus. 2021 Aug 5;13(8):e16917. doi: 10.7759/cureus.16917. eCollection 2021 Aug.

Asparaginase plays an integral role in chemotherapy for acute lymphoblastic leukemia (ALL). We present a 69-year old woman with refractory ALL, who developed asparaginase-induced hepatotoxicity and cholangiopathy after starting intravenous PEG-L-asparaginase-based chemotherapy. The patient was ultimately treated with the combination of L-carnitine and vitamin B complex, resulting in normalization of liver enzymes levels. This case highlights the consideration of PEG-L asparaginase chemotherapy-induced liver steatosis, injury, and cholangiopathy as well as the role of L-carnitine and vitamin B complex as treatment.

天冬酰胺酶在急性淋巴细胞白血病（ALL）的化疗中起着不可或缺的作用。我们报告了一名69岁患有难治性ALL的女性，在开始基于聚乙二醇化L-天冬酰胺酶的静脉化疗后出现了天冬酰胺酶诱导的肝毒性和胆管病。该患者最终接受了左旋肉碱和复合维生素B的联合治疗，结果肝酶水平恢复正常。该病例强调了对聚乙二醇化L-天冬酰胺酶化疗引起的肝脂肪变性、损伤和胆管病的考虑，以及左旋肉碱和复合维生素B作为治疗手段的作用。