Asparaginase-Associated Acute Pancreatitis—A Review

Abstract

Drugs remain a leading cause of acute pancreatitis (AP) in children. Asparaginase is a known cause of AP with reported incidence of up to 19%. The exact pathophysiology of asparaginase-associated pancreatitis (AAP) is unknown. Risk factors include age (older children/adolescents and adults), intermediate risk/high risk acute lymphoblastic leukemia (ALL) and presence of genetic mutations which appear to be an additive risk. It is associated with severe AP with increased morbidity and mortality.  Management is usually supportive and first involves stopping the medication, and then management of AP. Incidence of AAP upon rechallenge is high and should be avoided when possible.