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Asparaginase-associated pancreatitis in acute lymphoblastic leukemia: Results from the NOPHO ALL2008 treatment of patients 1-45 years of age

Journal of Clinical Oncology Dec 10, 2019

Rank CU, Wolthers BO, Frandsen TL, et al. - Given the common occurrence of asparaginase-associated pancreatitis (AAP) in patients with acute lymphoblastic leukemia (ALL), researchers sought to determine the risk differences across age groups both in relation to the first-time AAP and after asparaginase re-exposure. During the treatment of 2,448 consecutive ALL patients (aged 1.0-45.9 years) diagnosed from July 2008 to October 2018, 168 AAP were prospectively registered and were treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol. The analysis revealed that AAP risk was similar among older children and adults, however, adolescents exhibited most pronounced morbidity. They recommend considering asparaginase re-exposure only for patients with an anticipated high risk of leukemic relapse, in view of multiple studies strongly indicating an increased risk of relapse in correlation to reduction of asparaginase treatment intensity.
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