Y. S. Korkina, M. Shervashidze, T. T. Valiev, N. Batmanova, T. R. Panferova
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引用次数: 0
摘要
使用 L-天冬酰胺酶(L-ASP)强化治疗儿童急性淋巴细胞白血病可提高疗效,并显示出较高的存活率。这种酶具有独特的生物特性,可以通过降低血液中天冬酰胺的浓度来抑制肿瘤细胞的增殖。L-ASP 的使用受到毒性的限制,75% 的病例会出现超敏反应。虽然 L-ASP 治疗期间的大多数并发症都是轻度/中度的,并可通过适当的辅助治疗加以控制,但严重副作用的出现会导致被迫停用 L-ASP,这大大降低了急性淋巴细胞白血病患儿获得良好治疗结果的可能性。天冬酰胺酶相关性胰腺炎是最严重的毒性表现之一。它使预后恶化,并可能导致患者死亡。本文介绍了天冬酰胺酶相关性胰腺炎的最新数据,以及 N. N. Blokhin 国家肿瘤研究中心儿科肿瘤与血液学研究所对这种并发症的治疗经验。Blokhin 国家肿瘤学研究中心儿科肿瘤学和血液学研究所的治疗经验。
Successful treatment of pancreatitis caused by L-asparaginase in clinical practice
Treatment intensification of acute lymphoblastic leukemia in children with L-asparaginase (L-ASP) improves therapy effectiveness and shows high survival rates. The unique biological properties of this enzyme make it possible to suppress tumor blasts proliferation by reducing blood asparagine concentration. L-ASP use is limited by toxicity and hypersensitivity reactions observed in 75 % of cases. Although most complications during L-ASP therapy are mild/moderate and are manageable with adequate accompanying therapy, the development of severe side effects leads to forced withdrawal of L-ASP, which significantly reduces the likelihood of a favorable outcome in children with acute lymphoblastic leukemia. One of the most severe toxicity manifestations is the development of asparaginase-associated pancreatitis. It worsens the prognosis and may cause patients’ death. This article presents both current data about asparaginase-associated pancreatitis and treatment experience of this complication at the Research Institute of Pediatric Oncology and Hematology of the N. N. Blokhin National Research Center of Oncology.