Abstract
A patient with acute lymphoblastic leukemia repeatedly developed hypoglycemia during chemotherapy. Comparison of serum glucose trends between chemotherapy with and without L-asparaginase (L-Asp) demonstrated a strong association between L-Asp and hypoglycemia. Critical blood sampling during hypoglycemia indicated hyperinsulinism, suggesting that L-Asp induced hypoglycemia in the patient through inappropriate insulin secretion. Identification of hypoglycemia as an adverse effect will enable clinicians to understand and develop appropriate strategies for L-Asp use in chemotherapy regimens.
Highlights
The enzyme L-asparaginase (L-Asp) has been commonly used for treatment of childhood acute lymphoblastic leukemia (ALL) for more than 30 years [1,2,3]
When chemotherapy was resumed after 2 weeks of treatment for pancreatitis, L-Asp was excluded from protocol III of BFM 2000, which included dexamethasone, vincristine, doxorubicin, cyclophosphamide, cytarabine, mercaptopurine, and intrathecal methotrexate administration
Fasting glucose levels before and after the estimated L-Asp active period of induction therapy and during days 1–16 of protocol III were treated as values without L-Asp, whereas fasting glucose levels during the estimated L-Asp active period were treated as values with L-Asp
Summary
The enzyme L-asparaginase (L-Asp) has been commonly used for treatment of childhood acute lymphoblastic leukemia (ALL) for more than 30 years [1,2,3]. She repeatedly developed fasting hypoglycemia (glucose, 38–65 mg/dL) until day 37, without serious complications (Figure 1). During induction therapy, fasting glucose levels were always measured before the morning steroid dose.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
