Insulin infusion to treat severe hypertriglyceridemia associated with pegaspargase therapy: a case report.

Abstract

We describe a pediatric patient with acute leukemia who developed an uncommon but significant metabolic consequence of pegaspargase therapy-severe hypertriglyceridemia (hyperTG). We also relate our experience with continuous insulin infusion treatment for pegaspargase-induced hyperTG. This treatment approach led to a decrease in triglycerides from 4640 mg/dL on admission to 522 mg/dL at discharge 9 days later. Genetic testing revealed that our patient was an apolipoprotein E 3/4 heterozygote. Our review of the literature suggests that apolipoprotein E polymorphism may influence the development of hyperlipidemia in acute lymphoblastic leukemia patients receiving asparaginase therapy and may identify patients at high risk for developing asparaginase-induced hyperTG.

• Authors: Eileen B Lawson, Michael Gottschalk, Deborah E Schiff
• Journal: Journal of pediatric hematology/oncology (J Pediatr Hematol Oncol) Vol. 33 Issue 2 Pg. e83-6 (Mar 2011) ISSN: 1536-3678 [Electronic] United States
• PMID: 21343748 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Insulin
• Cytarabine
• Polyethylene Glycols
• pegaspargase
• Cyclophosphamide
• Mercaptopurine
• Asparaginase

Topics

• Antineoplastic Agents (adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Asparaginase (adverse effects)
• Child
• Cyclophosphamide (administration & dosage)
• Cytarabine (administration & dosage)
• Humans
• Hypertriglyceridemia (chemically induced, drug therapy)
• Infusions, Intravenous
• Insulin (administration & dosage)
• Leukemia (drug therapy)
• Male
• Mercaptopurine (administration & dosage)
• Polyethylene Glycols (adverse effects)