Clinical Analysis Of Asparaginase-associated Pancreatitis In Children

Objective: To investigate the clinical characteristics and the course of diagnosis and treatment of asparaginase associated pancreatitis(AAP)in children,aiming to improve the diagnosis and treatment of AAP,reduce the incidence of AAP and improve the prognosis.Methods: A total of 422 cases of acute lymphoblastic leukemia diagnosed and treated by chemotherapy in our hospital from January 2013 to December 2016 were retrospectively analyzed.All children were given PEG-Asp multi-drug combination chemotherapy.The occurrence,clinical manifestation,diagnosis,treatment and prognosis of AAP were analyzed.Results: In our hospital in the four years from 422 ALL patients with PEG-asp after chemotherapy,the incidence rate of APP was 4.5%(19/422).They were divided into AAP group and non AAP group,AAP children at the age of 86(29~153)months,54.3(13~170)months in non AAP group,P=0.002,P<0.05,the difference was statistically significant.There were no significant differences in the different chemotherapy regimens,clinical risk score,fusion gene and immunophenotype in the two groups,but there was no significant difference in P>0.05 between the two groups.Follow up to the end of December 2017,two groups in the rate of recurrence,the difference was not statistically significant.The median time of occurrence of AAP in 19 children with AAP was 10(1~25)days.57.9%(11/19)children were in the induction remission stage during chemotherapy,and 68.4%(13/19)children had AAP for the first time and second dose PEG-asp.Conclusion: This study found that the incidence of AAP in children with ALL combined with aspartate chemotherapy was 4.5%(19/422).Most of the children of AAP occurred in tenth days after the application of the aspartate.The age of children may be one of the risk factors for the occurrence of AAP.In addition,there was no correlation between sex,chemotherapy,risk grade,immunophenotype and fusion gene with the occurrence of AAP.