Pegaspargase-induced pancreatitis

✍ Scribed by Alvarez, Ofelia A.; Zimmerman, Grenith

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 122 KB
• Volume: 34
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/(sici)1096-911x(200003)34:3<200::aid-mpo7>3.0.co;2-t

✦ Synopsis

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/m(2) 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.