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KMID : 0366220170520010069
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Korean Journal of Hematology
2017 Volume.52 No. 1 p.69 ~ p.71
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Is N-acetylcysteine infusion an effective treatment option in L-asparaginase associated hepatotoxicity?
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Ozdemir Zeynep Canan
Turhan Ayse Bozkurt
Eren Makbule
Bor Ozcan
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Abstract
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TO THE EDITOR: L-asparaginase is an enzyme whose therapeutic effect has been well documented in children with acute lymphoblastic leukemia (ALL). The drug induces a relative asparagine deficiency that leads to the death of human lymphoblasts [1]. However, the mechanism of L-asparaginase-associated hepatotoxicity is not clear. There are few reports on the treatment of L-asparaginase-associated hepatotoxicity [234]. An experimental study conducted by Roesmann et al. [2] reported that when L-carnitine is administered in combination with L-asparaginase for steatosis, carnitine reduces the toxicity associated with L-asparaginase. Alshiekh-Nasany and Douer [3] reported that polyethylene glycol (PEG)-asparaginase related high-grade liver toxicity in adult patients could be rapidly and permanently reversed using the amino acid derivate L-carnitine. Al-Nawalki et al. [4] reported that histopathological macrovesicular steatosis was detected in 3 adult patients who developed L-asparaginase toxicity, and that the hepatotoxicity resolved after administration of carnitine and a vitamin B complex.
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