High-dose cytosine arabinoside-associated pancreatitis

Thirty patients with leukemia and lymphoma have been treated at our institution with high doses of cytosine arabinoside (Ara-C). Gastrointestinal symptoms were frequent after therapy, and 6 of the 30 patients had severe abdominal pain. Of the six, two had pancreatitis; two had normal amylase and lipase determinations; and in two, neither amylase nor lipase levels were determined. The two patients with pancreatitis are presented because this complication of high-dose Ara-C therapy has not been described. The authors conclude that pancreatitis can follow high-dose Ara-C chemotherapy and that patients with abdominal pain following this treatment be evaluated for pancreatitis.