BACKGROUND. While acute pancreatitis is a recognized complication of n
umerous drugs, cytarabine's role in causing this complication is contr
oversial. Approximately 15 cases have been reported io the Food and Dr
ug Administration linking cytarabine with pancreas-related toxicities.
Previous case reports have been complicated by comorbid illnesses and
the coadministration of other drugs associated with acute pancreatiti
s. METHODS. This report describes the clinical course of a patient wit
h acute myelogenous leukemia (AML) who developed recurrent pancreatiti
s associated with cytarabine therapy. RESULTS. A male age 36 years wit
h French-American-British M5B acute myelogenous leukemia received indu
ction cytarabine (200 mg/m(2)/day) by continuous infusion for days, an
d subsequently developed acute pancreatitis. The patient was rechallen
ged with intermittent, bolus, high dose cytarabine (HDAC) (3 g/m(2)bid
administered over 3 hours) during the following intensification treat
ment, but did not develop clinical acute pancreatitis. Retreatment wit
h continuous infusion cytarabine at a later time resulted in recurrenc
e of acute pancreatitis.CONCLUSIONS. This case illustrates that cytara
bine treatment may cause acute pancreatitis, and that this toxicity ma
y be schedule dependent. In those with known sensitivity to cytarabine
, altering the administration technique may avoid this complication. (
C) 1996 American Cancer Society.