Titre du document / Document title

Pegaspargase-induced pancreatitis

Auteur(s) / Author(s)

ALVAREZ O. A. ⁽¹⁾ ; ZIMMERMAN G. ⁽²⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Division of Hematology-Oncology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California, ETATS-UNIS
⁽²⁾ School of Allied Health Professions, Loma Linda University, Loma Linda, California, ETATS-UNIS

Résumé / Abstract

Background. The purpose of this study is to report the incidence of pancreatitis in patients treated with pegaspargase in our hospital during a 2-year period. Procedure. We identified episodes of pancreatitis related to the intramuscular administration of pegaspargase 2,500 IU/ m² for the treatment of childhood hematological malignancies during a 2-year period (May 1996-April 1998). Patients were evaluated clinically and by sequential serum amylase and lipase determinations and radiographic examinations. For comparison, episodes of pancreatitis in patients who only received native Escherichia coli L-asparaginase were examined during the same time period. Results. Nine children with acute lymphoblastic leukemia (ALL) of 50 (18%) patients who received pegaspargase were diagnosed to have pancreatitis. All had prior therapy with native L-asparaginase. These children developed symptoms consisting of abdominal pain, nausea, vomiting, and decreased appetite within a median of 15 days from the onset of pegaspargase administration. Six patients became symptomatic after their initial dose. Seven patients developed severe or unacceptable toxicity (grades 3 and 4), measured by increased amylase (>2 times normal) and lipase levels or radiographic evidence of pancreatic inflammation or pseudocyst. One patient also developed hyperammonemia and encephalopathy. In contrast, only one out of 52 (1.9%) ALL patients who received native E. coli L-asparaginase during the same time period developed pancreatitis (P= 0.007). Conclusion. Clinicians should be aware of a possible higher incidence of pancreatitis associated with pegaspargase.

Revue / Journal Title

Medical and pediatric oncology   ISSN 0098-1532   CODEN MPONDB 

Source / Source

2000, vol. 34, n^o3, pp. 200-205 (28 ref.)

Langue / Language

Anglais

Editeur / Publisher

Wiley-Liss, New York, NY, ETATS-UNIS  (1975-2003) (Revue)

Mots-clés anglais / English Keywords

Acute lymphocytic leukemia ; Non Hodgkin lymphoma ; Pegaspargase ; Asparaginase ; Chemotherapy ; Antineoplastic agent ; Pancreatitis ; Toxicity ; Pancreas ; Child ; Acute ; Hydrolases ; Enzyme ; Human ; Malignant hemopathy ; Lymphoproliferative syndrome ; Digestive diseases ; Pancreatic disease ;

Mots-clés français / French Keywords

Leucémie lymphoblastique ; Lymphome non hodgkinien ; Pégaspargase ; Asparaginase ; Chimiothérapie ; Anticancéreux ; Pancréatite ; Toxicité ; Pancréas ; Enfant ; Aigu ; Hydrolases ; Enzyme ; Homme ; Hémopathie maligne ; Lymphoprolifératif syndrome ; Appareil digestif pathologie ; Pancréas pathologie ;

Mots-clés espagnols / Spanish Keywords

Leucemia linfoblástica ; Linfoma no Hodgkin ; Pegaspargasa ; Asparaginase ; Quimioterapia ; Anticanceroso ; Pancreatitis ; Toxicidad ; Páncreas ; Niño ; Agudo ; Hydrolases ; Enzima ; Hombre ; Hemopatía maligna ; Linfoproliferativo síndrome ; Aparato digestivo patología ; Páncreas patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 15495, 35400008222482.0070