ABSTRACT
The aim of the study was to determine the side effects of asparaginase administration during treatment protocol for childhood non-Hodgkin's lymphoma (NHL). Drug adverse reactions occurred in 20/66 of patients (30,3%) treated in 9 centres in Poland between 1993 and 1998. The most common side effects were coagulation disturbances in 12/66 of the children (18,2%), which occurred due to reduced production of important coagulation factors. Six patients (9,1%) developed impairment of liver function (9,1%). Drug toxicity caused the modifications of treatment protocol in 12/66 (18,2%) of patients, mainly in the induction phase; 3 children died due to relapse of disease.
Subject(s)
Antineoplastic Agents/adverse effects , Asparaginase/adverse effects , Lymphoma, Non-Hodgkin/drug therapy , Adolescent , Anaphylaxis/chemically induced , Antineoplastic Agents/administration & dosage , Asparaginase/administration & dosage , Blood Coagulation Disorders/chemically induced , Chemical and Drug Induced Liver Injury , Child , Child, Preschool , Diabetes Mellitus/chemically induced , Female , Humans , Hyperlipidemias/chemically induced , Infant , Male , Pancreatitis/chemically induced , Poland , Retrospective Studies , Seizures/chemically induced , Time FactorsABSTRACT
From January 1994 until May 1997, 54 children with leukemia and non Hodgkin lymphoma were analyzed. The enzymatic function and ultrasound examination of pancreas were estimated. In 17 of 54 patients the clinical symptoms suggesting pancreatitis or toxic lesion of pancreas were observed. In 13 cases L-asparaginase was administered. The main symptom of the pancreas disease was severe abdominal pain with vomiting. The typical ultrasound view of pancreatitis was observed in 4 cases, pancreas oedema was seen in 6 patients. The most serious course of pancreatitis was diagnosed in 3 children. Diabetes mellitus coexisted in two cases, in the third case osteoporosis was seen. Because of the toxic pancreas lesion in one patient the administration of L-asparaginase and cortical hormones was discontinued, in the remaining 2 children the therapeutic scheme was modified. In all 17 cases this side effect was completely reversible, as well as in 3 children with the most serious clinical course of pancreas lesions.
Subject(s)
Asparaginase/therapeutic use , Hematologic Neoplasms/drug therapy , Lymphoma, Non-Hodgkin/drug therapy , Pancreatitis/chemically induced , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Abdominal Pain/etiology , Acute Disease , Adolescent , Antineoplastic Agents/adverse effects , Child , Child, Preschool , Female , Humans , Infant , Male , Pancreatitis/complications , Pancreatitis/diagnosis , Retrospective Studies , Severity of Illness Index , Treatment Outcome , Vomiting/etiologyABSTRACT
The treatment of the acute lymphoblastic leukemia in childhood includes frequent administration of L-asparaginase by intravenous route. L-asparaginase is an enzyme produced by E. coli and Erwinia chrysanthemi strains. Adverse reactions produced by L-asparaginase are numerous, and pancreatitis is being the most severe. Children with the acute lymphoblastic leukemia were followed up for 2 years. Hyperglycaemia and glycosuria were noted in 10% of them resulting in L-asparaginase cessation or replacement by less toxic agents. The acute pancreatitis was produced in 8% of the patients, and was treated typically.
