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

Shyam Srinivasan; Vikramjit Kanwar; Soumitra Saha; Raghavendra Gulabrao Mali; Tanveer Ahmed Shaikh; Renu Yadav; Anubha Jain

doi:10.1055/s-0042-1742615

Indian Journal of Medical and Paediatric Oncology, Table of Contents

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

¹Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India

,

Vikramjit Kanwar

¹Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India

,

Soumitra Saha

²Department of Pediatric Surgery, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India

,

Raghavendra Gulabrao Mali

³Department of Radiodiagnosis, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India

,

Tanveer Ahmed Shaikh

¹Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India

,

Renu Yadav

¹Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India

,

Anubha Jain

¹Department of Pediatric Oncology, Homi Bhabha Cancer Hospital, Homi Bhabha National Institute, Varanasi, Uttar Pradesh, India

› Author Affiliations

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

Full Text

References

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