Pegaspargase-induced hypertriglyceridemia in a patient with acute lymphoblastic leukemia.

Abstract

Pegaspargase, a long acting formulation of L-asparaginase, is an asparagine specific enzyme that selectively kills leukemic cells by depleting plasma asparagine. Pegaspargase is FDA approved for the first-line treatment of adult acute lymphoblastic leukemia and is a critical component of numerous multi-chemotherapeutic regimens. Pegaspargase is associated with well-described toxicities including hypersensitivity reactions, hepatotoxicity, and thrombosis. However, hypertriglyceridemia is a much rarer complication of pegaspargase and has only been described in a limited number of reports. We present a case of severe hypertriglyceridemia after a single dose of pegaspargase. The patient was re-challenged with pegaspargase and again developed hypertriglyceridemia which was complicated by pancreatitis. Here, we summarize published reports and a literature review describing the incidence of pegaspargase-induced hypertriglyceridemia in common acute lymphoblastic leukemia protocols.

• Authors: Kimberly M Lau, Ila M Saunders, Aaron Goodman
• Journal: Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners (J Oncol Pharm Pract) Vol. 26 Issue 1 Pg. 193-199 (Jan 2020) ISSN: 1477-092X [Electronic] England
• PMID: 30823860 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Antineoplastic Agents
• Polyethylene Glycols
• pegaspargase
• Asparaginase

Topics

• Adult
• Antineoplastic Agents (adverse effects)
• Asparaginase (adverse effects)
• Female
• Humans
• Hypertriglyceridemia (chemically induced)
• Polyethylene Glycols (adverse effects)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy)