Increased serum trypsin and elastase-1 levels in patients undergoing L-asparaginase therapy.
Although there is abundant literature on the association of L-asparaginase and acute pancreatitis in patients undergoing chemotherapy, few studies have investigated the usefulness of pancreatic enzyme measurement in the early diagnosis of L-asparaginase-induced acute pancreatitis. We measured levels of serum pancreatic enzymes before, during, and after L-asparaginase therapy in nine children with acute lymphocytic leukaemia or non-Hodgkin lymphoma. Serum levels of amylase, pancreatic isoamylase, and lipase did not change between the 1st and 30th day of L-asparaginase administration. However, the serum trypsin and elastase- levels, 10 and 20 days after beginning L-asparaginase therapy, were significantly higher than those prior to therapy.


CONCLUSIONS
L-asparaginase may induce subclinical pancreatitis and the estimation of serum trypsin and elastase-1 may be useful in the early diagnosis of L-asparaginase-induced acute pancreatitis.
Department of Paediatrics, Juntendo University, Tokyo, Japan.
T
T
Shimizu
Y
Y
Yamashiro
J
J
Igarashi
H
H
Fujita
K
K
Ishimoto
D000208:Acute Disease; D000293:Adolescent; D000681:Amylases / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001215:Asparaginase / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007517:Isoamylase / Q000097:blood; D008049:Lipase / Q000097:blood; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D010196:Pancreatic Elastase / Q000097:blood*; D010195:Pancreatitis / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D014357:Trypsin / Q000097:blood*
D000970:Antineoplastic Agents; D008049:Lipase; D000681:Amylases; D007517:Isoamylase; D010196:Pancreatic Elastase; D014357:Trypsin; D001215:Asparaginase