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Levocarnitine for asparaginase-induced hepatic injury: a multi-institutional case series and review of the literature.
- Source :
-
Leukemia & lymphoma [Leuk Lymphoma] 2018 Oct; Vol. 59 (10), pp. 2360-2368. Date of Electronic Publication: 2018 Feb 12. - Publication Year :
- 2018
-
Abstract
- Asparaginase, an important treatment component for acute lymphoblastic leukemia (ALL), causes severe hepatotoxicity in some patients. Levocarnitine is a mitochondrial co-factor that can potentially ameliorate the mitochondrial toxicity of asparaginase. In this retrospective case series, we describe the clinical presentation and management of six pediatric and young adult patients (mean age 12.7, range 9-24 years) with ALL who developed Grade 3-4 hyperbilirubinemia following administration of asparaginase as part of induction/re-induction therapy. Five of these patients were treated with levocarnitine with subsequent improvement of hyperbilirubinemia, while one patient was given levocarnitine prophylactically during induction and developed Grade 3 hyperbilirubinemia, but did not require therapy adjustments or delays. Increased awareness in the pediatric oncology community regarding asparaginase-associated hepatic toxicity and the potential role of levocarnitine in management is warranted.
- Subjects :
- Adult
Chemical and Drug Induced Liver Injury blood
Chemical and Drug Induced Liver Injury diagnosis
Chemical and Drug Induced Liver Injury etiology
Child
Female
Humans
Hyperbilirubinemia blood
Hyperbilirubinemia diagnosis
Hyperbilirubinemia etiology
Liver diagnostic imaging
Liver drug effects
Liver Function Tests
Male
Remission Induction methods
Treatment Outcome
Ultrasonography
Young Adult
Antineoplastic Combined Chemotherapy Protocols adverse effects
Asparaginase adverse effects
Carnitine therapeutic use
Chemical and Drug Induced Liver Injury drug therapy
Hyperbilirubinemia drug therapy
Polyethylene Glycols adverse effects
Precursor Cell Lymphoblastic Leukemia-Lymphoma drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1029-2403
- Volume :
- 59
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Leukemia & lymphoma
- Publication Type :
- Academic Journal
- Accession number :
- 29431566
- Full Text :
- https://doi.org/10.1080/10428194.2018.1435873