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Predicting asparaginase-associated pancreatitis
Holly M Knoderer1, Jason Robarge, David A Flockhart
1Department of Pediatric Hematology-Oncology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA. htalley@iupui.edu
Pediatric Blood & Cancer
|August 29, 2006
Summary
Asparaginase-associated pancreatitis (AAP) affects 19% of patients, with no clear predictors. Genetic predisposition may play a role in developing this asparaginase complication.
Area of Science:
- Oncology
- Pharmacology
- Gastroenterology
Background:
- Asparaginase is a crucial chemotherapy agent.
- Asparaginase-associated pancreatitis (AAP) is a known but poorly understood complication.
- Predictors for developing AAP are currently lacking.
Purpose of the Study:
- To retrospectively analyze asparaginase-associated pancreatitis (AAP) in a patient cohort.
- To review existing literature on AAP.
- To identify potential risk factors and characteristics of patients who develop AAP.
Main Methods:
- Systematic review of medical records for 254 asparaginase recipients over 5 years.
- Pancreatitis diagnosis and grading based on CTCAE v3.0 criteria.
- Statistical analysis to identify associations between AAP and patient/treatment factors.
Main Results:
- 19% of patients developed pancreatitis; 13% had confirmed AAP.
- AAP occurred after both E. coli and PEG-asparaginase, with a longer diagnosis interval for PEG-asparaginase.
- AAP was associated with prednisone and daunomycin, and inversely with dexamethasone; older age was also noted.
Conclusions:
- The study highlights the difficulty in predicting which patients will develop pancreatic toxicity from asparaginase.
- An unidentified genetic predisposition may contribute to the risk of developing AAP.
- Further research is needed to elucidate the underlying mechanisms and identify predictive markers for AAP.
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