Hoogerbrugge N, Jansen H, Hoogerbrugge P M
Leukemia. 1997 Aug;11(8):1377-9. doi: 10.1038/sj.leu.2400703.
A 13-year-old girl with acute lymphoblastic leukemia (ALL) developed extremely high plasma triglyceride (TG) concentrations of 103 mmol/l (reference value <1.8 mmol/l) during combination treatment with corticosteroids and asparaginase. Corticosteroids are known to induce the production of TG-rich particles. On the other hand, corticosteroids increase the activity of lipoprotein lipase (LPL), a key enzyme in the removal of TG from plasma. Generally, the increased LPL activity prevents an extreme rise in TG levels upon therapy with corticosteroids. In our patient, we found that the corticosteroid-induced LPL activity dramatically declined after therapy with L-asparaginase. This suggests that the extensive hypertriglyceridemia in our patient was due to an L-asparaginase-induced decrease in LPL activity. This hypothesis was further supported by the finding that hypertriglyceridemia was less severe when corticosteroids and asparaginase were given separately.
一名13岁的急性淋巴细胞白血病（ALL）女孩在接受皮质类固醇和天冬酰胺酶联合治疗期间，血浆甘油三酯（TG）浓度极高，达103 mmol/L（参考值<1.8 mmol/L）。已知皮质类固醇会诱导富含TG的颗粒生成。另一方面，皮质类固醇会增加脂蛋白脂肪酶（LPL）的活性，LPL是从血浆中清除TG的关键酶。一般来说，LPL活性增加可防止皮质类固醇治疗时TG水平极度升高。在我们的患者中，我们发现皮质类固醇诱导的LPL活性在接受L-天冬酰胺酶治疗后急剧下降。这表明我们患者中广泛的高甘油三酯血症是由于L-天冬酰胺酶诱导的LPL活性降低所致。当分别给予皮质类固醇和天冬酰胺酶时高甘油三酯血症较轻这一发现进一步支持了这一假设。
