Asparaginase-Associated Acute Pancreatitis—A Review

Chinenye Dike; Sohail Husain

doi:10.69734/rg9vhg12

Authors

Chinenye R. Dike MD, MS University of Alabama at Birmingham Author https://orcid.org/0000-0003-2435-3655
Sohail Z. Husain MD 2. Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Stanford University, CA, USA. Author https://orcid.org/0000-0003-3012-1308

DOI:

https://doi.org/10.69734/rg9vhg12

Keywords:

oncology, acute lymphoblastic leukemia, asparaginase, acute pancreatitis, recurrent acute pancreatitis, hyperlipidemia, asparaginase-lassociated pancreatitis, drug-induced pancreatitis, PEG-asparaginase, calaspargase pegol, pediatric ALL, chemotherapy toxicity, pediatric pancreatitis, INSPPIRE, NASPGHAN, CTCAE grading, asparaginase rechallenge, exocrine pancreatic insufficiency, vitamin A, retinoids, PRSS1, PRSS1-PRSS2, CTRC, machine learning, octreotide prophylaxis

Abstract

Drugs remain a leading cause of acute pancreatitis (AP) in children. Asparaginase is a known cause of AP with reported incidence of up to 19%. The exact pathophysiology of asparaginase-associated pancreatitis (AAP) is unknown. Risk factors include age (older children/adolescents and adults), intermediate risk/high risk acute lymphoblastic leukemia (ALL) and presence of genetic mutations which appear to be an additive risk. It is associated with severe AP with increased morbidity and mortality. Management is usually supportive and first involves stopping the medication, and then management of AP. Incidence of AAP upon rechallenge is high and should be avoided when possible.

Author Biographies

Chinenye R. Dike MD, MS, University of Alabama at Birmingham

Associate Professor of Pediatrics
Sohail Z. Husain MD, 2. Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Stanford University, CA, USA.

Chambers-Okamura Endowed Professor of Pediatric Gastroenterology at Stanford

Chief, Division of Gastroenterology, Hepatology, and Nutrition at Stanford and Stanford Medicine Children's Health

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Asparaginase-Associated Acute Pancreatitis—A Review

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