HYPERGLYCEMIA, KETOACIDOSIS AND OTHER COMPLICATIONS OF L-ASPARAGINASEIN CHILDREN WITH ACUTE LYMPHOBLASTIC-LEUKEMIA

We show Escherichia coli derived L-asparaginase complications observed in 14 of 136 acute lymphoblastic leukemia patients during remission i nduction therapy according to St. Jude Children's Hospital Total XI Pr otocol. We observed hyperglycemia in six patients; two of them had acc ompanying ketoacidosis. One of the cases with ketoacidosis had periton itis and pancreatitis. Central nervous system symptoms such as convuls ions and depression with personality changes (in one case) were observ ed in four of these six hyperglycemic patients. Intracranial bleeding and ischemic infarction were shown in cranial computed tomographies in two cases. Hypersensitivity reactions were observed in seven patients . Patients were randomly assigned into two groups and treated with con ventional dose steroids or high dose methylprednisolone. Although the frequency of hypersensitivity reactions were lower in the high dose me thylprednisolone group, one patient in this group had an anaphylactic reaction. These findings once again high-light L-asparaginase complica tions which are not dose dependent and can be life threatening.