Posterior Reversible Encephalopathy Syndrome in the Setting of Asparaginase-associated Pancreatitis in 2 Pediatric Patients With Acute Leukemia

J Pediatr Hematol Oncol. 2022 Apr 1;44(3):e709-e712. doi: 10.1097/MPH.0000000000002367.

Abstract

Asparaginase, a critical component of current pediatric acute leukemia treatment protocols, is associated with a number of serious side effects, one of which is pancreatitis. Pancreatitis can result in significant morbidity and mortality from necrosis, pseudocyst formation, hemorrhage, systemic inflammation, intestinal perforation, and sepsis. Another rare complication of pancreatitis is posterior reversible encephalopathy syndrome, likely mediated by systemic inflammation secondary to pancreatic autodigestion and proinflammatory cytokine-mediated vascular endothelial damage. Here, we review this association in the literature and report 2 pediatric patients with leukemia who developed posterior reversible encephalopathy syndrome in the setting of asparaginase-associated pancreatitis.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Asparaginase / adverse effects
  • Child
  • Humans
  • Inflammation / complications
  • Leukemia, Myeloid, Acute* / drug therapy
  • Pancreatitis* / chemically induced
  • Pancreatitis* / drug therapy
  • Posterior Leukoencephalopathy Syndrome* / chemically induced
  • Posterior Leukoencephalopathy Syndrome* / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy

Substances

  • Asparaginase