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Abstract
Introduction. Asparaginase (ASP) is an essential antitumor agent in multiagent therapy for acute lymphoblastic leukemia (ALL) and plays a key role in improving survival rates. However, it should be noted that there is a high risk of associated toxicity, including hypersensitivity reactions, thrombotic events, pancreatitis, liver dysfunction and other less frequent events that require the attention of medical professionals of all specialties and immediate modification of concomitant therapy.
Case description. We present rare clinical cases of severe hypertriglyceridemia (HT) in adolescent patients with B-ALL following the use of a pegylated form of ASP (PEG-ASP). The complications that developed in our patients led to a deterioration in their health, with an increased risk of life-threatening conditions, and were a contraindication to further anti-cancer treatment. Prompt diagnosis and correct treatment strategy, including therapeutic apheresis (plasma exchange, double filtration plasmapheresis), heparinization, diet and corrective infusion therapy, helped to eliminate this variant of toxicity.
Conclusion. The article reviews international literature data on risk factors, epidemiology and management of HT in pediatric patients associated with ASP therapy. Lipid metabolism and molecular genetic testing (to exclude hereditary forms of hypercholesterolemia) should be included in routine screening of adolescents and young adults on ASP therapy.
References
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