Pegaspargase-induced pancreatitis

Ofelia A. Alvarez, Grenith Zimmerman

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

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. (C) 2000 Wiley-Liss, Inc.

Original languageEnglish (US)
Pages (from-to)200-205
Number of pages6
JournalMedical and Pediatric Oncology
Volume34
Issue number3
DOIs
StatePublished - Mar 1 2000
Externally publishedYes

Keywords

  • Childhood leukemia
  • L-asparaginase
  • Pancreatitis
  • PEG
  • Pegaspargase

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Oncology
  • Cancer Research

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