L-asparaginase-induced severe necrotizing pancreatitis successfully treated with percutaneous drainage

L‐asparaginase is a key component of the antileukemic therapy in children with acute lymphoblastic leukemia (ALL). Pancreatitis has been noted to be a complication in 2–16% of patients undergoing treatment with L‐asparaginase for a variety of pediatric neoplasms. Most cases of pancreatitis associate...

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Published in:Pediatric Blood & Cancer 2005-01, Vol.44 (1), p.95-97
Main Authors: Top, P.C., Tissing, W.J.E., Kuiper, J.W., Pieters, R., van Eijck, C.H.J.
Format: Article
Language:English
Subjects:
Adolescent
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
asparaginase
Asparaginase - adverse effects
Asparaginase - therapeutic use
child
conservative therapy
Drainage - methods
Female
Humans
necrotizing pancreatitis
Pancreatitis, Acute Necrotizing - chemically induced
Pancreatitis, Acute Necrotizing - therapy
percutaneous drainage
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Treatment Outcome
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Summary:L‐asparaginase is a key component of the antileukemic therapy in children with acute lymphoblastic leukemia (ALL). Pancreatitis has been noted to be a complication in 2–16% of patients undergoing treatment with L‐asparaginase for a variety of pediatric neoplasms. Most cases of pancreatitis associated with L‐asparaginase toxicity are self‐limiting and respond favorably to nasogastric decompression and intravenous hyperalimentation. However, in rare instances, hemorrhagic pancreatitis or necrosis may occur. L‐asparaginase‐induced pancreatitis is an uncommon but potential lethal complication of the treatment of leukemia. We present a pediatric patient with leukemia and a severe, L‐asparaginase‐induced necrotizing pancreatitis, treated successfully with percutaneous drainage used to flush the infected necrotic parts. © 2004 Wiley‐Liss, Inc.
ISSN:1545-5009
1545-5017
1096-911X
DOI:10.1002/pbc.20187