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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Pharmacotherapy The ...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy
Article . 2014 . Peer-reviewed
License: Wiley Online Library User Agreement
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Successful Use of Octreotide as a Chemoprotectant for Prevention of PEG‐Asparaginase–Induced Pancreatitis

Authors: Larry W, Buie; Joseph, Moore; Hank, van Deventer;

Successful Use of Octreotide as a Chemoprotectant for Prevention of PEG‐Asparaginase–Induced Pancreatitis

Abstract

l‐asparaginase is an aminohydrolase that deprives leukemia cells of l‐asparagine required for protein synthesis. Although studies in patients with acute lymphoblastic leukemia have shown that the addition of l‐asparaginase improved the overall remission rate, life‐threatening acute pancreatitis has occurred in 0.5–4% of patients. We describe the first adult case report, to our knowledge, of the successful use of octreotide as a chemoprotectant for the prevention of recurrent pegylated asparaginase (PEG‐ASP)–induced pancreatitis in a 21‐year‐old man with Philadelphia chromosome–negative acute lymphoblastic leukemia. After recurrent PEG‐ASP administration during induction chemotherapy, he developed necrotizing pancreatitis, confirmed by abdominal computed tomography, and further asparaginase therapy was withheld. Currently, there are no specific treatment recommendations for the management of asparaginase‐induced pancreatitis other than drug discontinuation. After disease relapse, a pediatric PEG‐ASP–containing regimen was initiated, and PEG‐ASP therapy was resumed due to its potential clinical benefit. Octreotide 100 μg subcutaneously 3 times/day, utilized as a chemoprotectant, was found to prevent pancreatitis recurrence. The patient completed therapy and was able to receive a bone marrow transplant without further complications from PEG‐ASP therapy. Based on this patient's experience, we believe it is reasonable to reincorporate PEG‐ASP after an episode of pancreatitis with use of octreotide as a chemoprotectant; however, this conclusion will need to be substantiated in a randomized clinical trial with a larger group of patients.

Keywords

Male, Antineoplastic Agents, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Octreotide, Polyethylene Glycols, Young Adult, Gastrointestinal Agents, Pancreatitis, Recurrence, Asparaginase, Humans

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
11
Top 10%
Top 10%
Top 10%
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