[Analysis of Clinical Characteristics and Prognosis of Asparaginase-Associated Pancreatitis in Children with Acute Lymphoblastic Leukemia].
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OBJECTIVE: To analyze the clinical features and prognosis of children with acute lymphoblastic leukemia (ALL) complicated with asparaginase-associated pancreatitis (AAP). METHODS: The clinical data of pediatric ALL patients treated with the CCLG-ALL2018 regimen at the Children's Hospital affiliated to Zhengzhou University from April 2018 to December 2022 who developed AAP were retrospectively collected, and their clinical characteristics and prognosis were analyzed. The clinical and laboratory indicators were compared among different severity levels of pancreatitis, and their associations with disease severity were analyzed. RESULTS: The incidence of AAP in ALL was 6.11% (27/442), with a median age of 6.83 years (10 months to 14 years). 40.74% (11/27) of AAP occurred after the second administration of PEG-asparaginase (PEG-Asp), with an average of 3.9 administrations of PEG-Asp before AAP onset. The incidence of AAP in high-risk children was significantly higher than that in low- and intermediate-risk children (both P <0.05). The differences in triglyceride, blood glucose, and PEG-Asp levels were statistically significant between children with mild and moderately severe pancreatitis (all P <0.05). The 4-year overall survival (OS) rate and cumulative incidence of relapse (CIR) of AAP children were 88.10% and 11.43%, respectively, while those of non-AAP children were 88.00% and 12.29%, showing similar outcomes between the two groups (P >0.05). CONCLUSION: AAP occurs more frequently in the early stages of chemotherapy, and its occurrence is not related to the prognosis of ALL. Moreover, the incidence of AAP is higher in high-risk children. Higher triglyceride and blood glucose levels or lower blood sodium level may indicate more severe disease, thus it is necessary to enhance monitoring after treatment.