Levocarnitine for asparaginase-induced hepatic injury: a multi-institutional case series and review of the literature
| Autor: | Adam S. DuVall, Rachael R. Schulte, Jessica Hochberg, Jennifer L. McNeer, Archie Bleyer, Allyson Flower, Manasi Vivek Madiwale, Michael J. Burke |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Asparaginase Lymphoblastic Leukemia Article Polyethylene Glycols Levocarnitine Young Adult 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Liver Function Tests Carnitine Internal medicine Antineoplastic Combined Chemotherapy Protocols Pediatric oncology medicine Humans Young adult Child Hyperbilirubinemia Ultrasonography business.industry Remission Induction Mean age Hematology Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Leukemia Mitochondrial toxicity Treatment Outcome Liver Oncology chemistry 030220 oncology & carcinogenesis Female Chemical and Drug Induced Liver Injury business 030215 immunology |
| Zdroj: | Leuk Lymphoma |
| ISSN: | 1029-2403 1042-8194 |
| DOI: | 10.1080/10428194.2018.1435873 |
| Popis: | Asparaginase, an important treatment component for acute lymphoblastic leukemia (ALL), causes severe hepatotoxicity in some patients. Levocarnitine is a mitochondrial co-factor that can potentially ameliorate the mitochondrial toxicity of asparaginase. In this retrospective case series, we describe the clinical presentation and management of six pediatric and young adult patients (mean age 12.7, range 9–24 years) with ALL who developed Grade 3–4 hyperbilirubinemia following administration of asparaginase as part of induction/re-induction therapy. Five of these patients were treated with levocarnitine with subsequent improvement of hyperbilirubinemia, while one patient was given levocarnitine prophylactically during induction and developed Grade 3 hyperbilirubinemia, but did not require therapy adjustments or delays. Increased awareness in the pediatric oncology community regarding asparaginase-associated hepatic toxicity and the potential role of levocarnitine in management is warranted. |
| Databáze: | OpenAIRE |
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