Clinical characteristics and prognostic analysis of asparaginase-associated pancreatitis in pediatric acute lymphoblastic leukemia
10.12354/j.issn.1000-8179.2024.20240596
- VernacularTitle:儿童急性淋巴细胞白血病门冬酰胺酶相关胰腺炎的临床特征及预后分析
- Author:
Dun JIANXIN
1
;
Zhang AI
;
Wang YAQIN
;
Wang YAO
;
Liu AIGUO
;
Hu QUN
Author Information
1. 华中科技大学同济医学院附属同济医院儿童血液科(武汉市 430030)
- Keywords:
asparaginase(ASP);
pancreatitis;
child;
acute lymphoblastic leukemia(ALL)
- From:
Chinese Journal of Clinical Oncology
2024;51(11):547-551
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics and risk factors of asparaginase-associated pancreatitis(AAP)in children with acute lymphoblastic leukemia(ALL),and to investigate the impact of AAP on their prognosis following re-exposure to asparaginase(ASP).Methods:Clinical children data with ALL at Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology between January 2015 and June 2020 were collected to analyze the clinical features of AAP.Logistic regression was used to identify risk factors for AAP.Prognostic analysis was performed using the Log-rank test and Kaplan-Meier survival curves.Results:Overall,252 children with ALL were included,among whom 23(9.1%)developed AAP.Most AAP cases(82.6%)occurred during remission induction,with a medi-an time from the last ASP to AAP of 12 d.Elevated total cholesterol(≥3.5 mmol/L)at initial diagnosis was identified as an independent risk factor.Six children(26.1%)were re-exposed to ASP,leading to recurrent pancreatitis in 3 cases.The 5-year overall survival(OS)was signific-antly lower in the AAP group(78.3%±8.6%)compared to the non-AAP group(90.3%±2.2%)(P<0.05).Similarly,children who discontinued ASP due to AAP had a 5-year OS of 77.8%±9.8%,significantly lower than the control group(90.1%±2.1%).Conclusions:AAP typically oc-curred within 12 d of the last ASP administration and was associated with poorer 5-year OS.Re-exposure to ASP posed a risk of recurrent AAP;however,completing the ASP chemotherapy regimen may be crucial for improving prognosis.
