TITLE:
Transient Diabetes Induced by L-Asparaginase
AUTHORS:
Mamadou Moustapha Diop, M’mah Aminata Bangoura, Aissata Barry, Emmanuel Camara, Kolié Ouo Ouo, Pé Neabei Beimy, Mohamed Lamine Diallo, Kaba Bangoura, Moustapha Kouyate, Mohamed Lamine Kaba, Aka Nbga
KEYWORDS:
Asparaginase, Diabetes, ALL, Donka
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.13 No.6,
November
9,
2023
ABSTRACT: Background: Although hyperglycaemia is one of the known side effects of
L-asparaginase, its contribution to the development of diabetic ketoacidosis
(DKA) is less well known in the literature. Asparaginase is an essential
component of treatment protocols for acute lymphoblastic leukaemia (ALL) in
combination with other chemotherapeutic drugs. On further evaluation, she was
found to have high anion gap metabolic acidosis, hyperglycaemia and ketonuria.
In recent decades, the use of these chemotherapeutic agents has led to a
decrease in mortality and disease-free survival in ALL. L-asparaginase is one
of the chemotherapy protocols used in the treatment of acute lymphoblastic
leukaemia (ALL) and can induce hyperglycaemia which is aggravated by the
concomitant use of corticosteroids. We report the observation of a 14-year-old
girl treated with chemotherapy (GFA LAL protocol) who developed transient
diabetes following the use of L-asparaginase. She was treated at the Donka
paediatric haemato-oncology unit by a multidisciplinary team including a
paediatric oncologist, a psychologist and a diabetologist. The aim of this
study was to highlight blood glucose monitoring before and after the use of
asparaginase in acute lymphoblastic leukaemia. Conclusion: We conclude that the
occurrence of ketoacidosis following the use of asparaginase is a rare event.
We recommend close monitoring of blood glucose levels for hyperglycaemia in
patients with ALL receiving L-asparaginase.