Fulminant hepatitis possibly caused by L-asparaginase during induction chemotherapy in a patient with acute lymphoblastic leukemia

DOI Web Site PubMed 10 References
  • TSUTSUI Miyuki
    Department of Hematology, Juntendo University School of Medicine
  • KOIKE Michiaki
    Department of Hematology, Juntendo University Shizuoka Hospital
  • KOMATSU Norio
    Department of Hematology, Juntendo University School of Medicine

Bibliographic Information

Other Title
  • 寛解導入療法中にL-アスパラギナーゼによると思われる劇症肝炎を併発した急性リンパ性白血病
  • 症例報告〈第166回日本血液学会例会 : 桐戸敬太会長 推薦演題〉 寛解導入療法中にL-アスパラギナーゼによると思われる劇症肝炎を併発した急性リンパ性白血病
  • ショウレイ ホウコク 〈 ダイ166カイ ニホン ケツエキ ガッカイ レイカイ : キリドケイタイカイチョウ スイセン エンダイ 〉 カンカイドウニュウ リョウホウ チュウ ニ L-アスパラギナーゼ ニ ヨル ト オモワレル ゲキショウ カンエン オ ヘイハツ シタ キュウセイ リンパセイ ハッケツビョウ

Search this article

Description

We report a 44-year-old man with acute lymphoblastic leukemia (ALL) presenting with fever and lymphadenopathy. Induction chemotherapy was initialed according to the JALSG ALL202 protocol, and L-asparaginase (L-asp) was given on days 20, 22, and 24 of therapy. Abrupt elevations of liver transaminase and bilirubin levels were observed on day 26. On day 30, coagulopathy and hepatic encephalopathy appeared. He was diagnosed with fulminant hepatitis and plasma exchange was performed, but he died on day 32, possibly due to L-asp-induced hepatitis. The common side effects of L-asp are hypersensitivity, ammonemia, coagulopathy, pancreatitis, convulsions, anaphylaxis, hepatotoxicity, and thrombosis. Although rare, reports of deaths due to hepatic failure during treatment with L-asp exist. L-asp is currently used for treatment of a wide range of hematological malignancies such as ALL and NK/T-cell lymphoma. A retrospective analysis of patients treated with L-asp should be carried out to elucidate the incidence and risk factors of liver dysfunction and fulminant hepatitis during L-asp treatment.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 53 (5), 531-534, 2012

    The Japanese Society of Hematology

References(10)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top