Incidence and outcome of pancreatitis in children and young adults with acute lymphoblastic leukaemia treated on a contemporary protocol, UKALL 2003

摘要

Acute Pancreatitis is a well-known complication of the treatment of childhood acute lymphoblastic leukaemia (ALL). Pancreatitis is associated with significant complications, such as multiorgan failure and pseudocysts. The incidence of pancreatitis following ALL treatment is 7-18% (Raja et al, 2012), and this variation is due to differences in the definition of pancreatitis and variations in the doses of anti-leukaemic medications that cause pancreatitis. Whilst numerous anti-leukaemic medications have been reported to cause pancreatitis, the most important is Asparaginase. The development of pancreatitis is one of the commonest causes for stopping Asparaginase, because re-exposure is associated with recurrence. In contrast, stopping scheduled Asparaginase treatment because of previous pancreatitis has been linked to an increased relapse rate (Silverman et al, 2001). Recently, recommendations for the reintroduc-tion of Asparaginase based on clinical criteria were suggested in attempt to minimize the risk of relapse without compromising safely (Raja et al, 2012). We therefore conducted a retrospective review of the clinical risk factors and outcome of pancreatitis on the recently closed UKALL 2003 trial.