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Symptomatic severe hypertriglyceridaemia with asparaginase therapy in acute lymphoblastic leukaemia (ALL) and lymphoblastic lymphoma: is rechallenging safe?

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Abstract

Severe hyperlipidaemia with asparaginase therapy is rare. We report six cases, four of which developed significant problems with severe hyperlipidaemia during induction therapy for ALL and lymphoblastic lymphoma. The median triglyceride level was 22.3 mmol/L and the median cholesterol level was 12.3 mmol/L. None of the patients showed signs or symptoms of pancreatitis. Three children were re-exposed with Peg asparaginase, and one with Erwinia asparaginase, without recurrence of hyperlipidaemia or other symptoms. These cases highlight the dilemma in managing such rare cases of symptomatic hypertriglyceridaemia secondary to asparaginase and steroid therapy.

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Authors and Affiliations

  1. The Royal Marsden Hospital NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK

    Harsha Prasada Lashkari, Donna Lancaster, Ayad Atra & Mary M. Taj

  2. Department of Inherited Metabolic Disease, Evelina Children’s Hospital, Guys and St Thomas NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK

    Michael P. Champion

  3. Specialist Registrar in Paediatric Oncology, The Royal Marsden Hospital NHS Foundation Trust, Downs Road, Sutton, Surrey, SM2 5PT, UK

    Harsha Prasada Lashkari

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  1. Harsha Prasada Lashkari
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  2. Donna Lancaster
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  3. Ayad Atra
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  4. Michael P. Champion
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  5. Mary M. Taj
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Correspondence to Harsha Prasada Lashkari.

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Lashkari, H.P., Lancaster, D., Atra, A. et al. Symptomatic severe hypertriglyceridaemia with asparaginase therapy in acute lymphoblastic leukaemia (ALL) and lymphoblastic lymphoma: is rechallenging safe?. Int J Hematol 94, 571–575 (2011). https://doi.org/10.1007/s12185-011-0966-9

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  • DOI: https://doi.org/10.1007/s12185-011-0966-9

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