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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2022; 43(05): 443-447
DOI: 10.1055/s-0042-1742615
Case Report with Review of Literature

Multiple Complications Secondary to L-asparaginase In a Child with Philadelphia-Chromosome-Positive Acute Lymphoblastic Leukemia: Case Report with Review of Literature

Shyam Srinivasan 
1   Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India
,
Vikramjit Kanwar 
1   Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India
,
Soumitra Saha
2   Department of Pediatric Surgery, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India
,
Raghavendra Gulabrao Mali
3   Department of Radiodiagnosis, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India
,
Tanveer Ahmed Shaikh
1   Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India
,
Renu Yadav
1   Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India
,
Anubha Jain
1   Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India
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Abstract

Even though L-asparaginase remains an essential drug for the treatment of childhood acute lymphoblastic leukemia (ALL), its use is associated with several unique toxicities. In this care report, we discuss a young boy with ALL who developed multiple complications simultaneously, including pancreatitis, gastrointestinal perforation, and left ventricular thrombus secondary to L-asparaginase during induction chemotherapy. Patient received immediate surgical intervention for the perforation and was commenced on anticoagulation therapy for the thrombus but eventually expired. This report highlights the importance of being aware of toxicities secondary to the use of L-asparaginase. Multiple complications secondary to L-asparaginase have been rarely reported previously and can be fatal.

Keywords

Philadelphia-chromosome-positive acute lymphoblastic leukemia - acute pancreatitis - ventricular thrombus - gastric perforation - L-asparaginase

Source of Support

None.


Declaration of Patient Consent

The authors certify that they have obtained all appropriate patient consent forms.




Publication History

Article published online:
21 April 2022

© 2022. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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