PDF(Pubmed)
Abstract：
Pegylated (PEG)-asparaginase is used during the induction and intensification phases of treatment for B-cell acute lymphoblastic leukemia (B-ALL). It works by depleting the external sources of asparagine, causing the death of lymphoblasts. It has several adverse effects, including pancreatitis and hypertriglyceridemia; however, the simultaneous occurrence of both is uncommon. We present the case of an 18-year-old man with B-ALL who developed acute epigastric pain radiating to the back and non-bloody, non-bilious emesis following treatment with PEG-asparaginase. He was diagnosed with acute interstitial pancreatitis and severe hypertriglyceridemia. Conservative management was used for the pancreatitis, while hypertriglyceridemia was treated with an insulin infusion. Pancreatic toxicity and hypertriglyceridemia can necessitate the discontinuation of PEG-asparaginase, limiting treatment options and potentially increasing the risk of relapse. Therefore, further studies are needed to identify the factors contributing to hypertriglyceridemia and pancreatitis, aiding clinicians in monitoring and prevention.
摘要：
聚乙二醇化（PEG）-天冬酰胺酶用于B细胞急性淋巴细胞白血病（B-ALL）治疗的诱导和强化阶段。它通过消耗天冬酰胺的外部来源起作用，导致淋巴母细胞死亡.它有几个不良影响，包括胰腺炎和高甘油三酯血症；然而，两者同时发生并不常见。我们介绍了一个患有B-ALL的18岁男子的病例，他出现了急性上腹痛，向背部放射并且没有流血，用PEG-天冬酰胺酶治疗后的非胆汁性呕吐。他被诊断为急性间质性胰腺炎和严重的高甘油三酯血症。对胰腺炎采用保守治疗,而高甘油三酯血症用胰岛素输注治疗。胰腺毒性和高甘油三酯血症可能需要停止PEG-天冬酰胺酶，限制治疗选择并可能增加复发风险。因此,需要进一步的研究来确定导致高甘油三酯血症和胰腺炎的因素，帮助临床医生监测和预防。
