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Open Access Case report

Hypoglycemia associated with L-asparaginase in acute lymphoblastic leukemia treatment: a case report

Ryuma Tanaka, Tomoo Osumi, Masashi Miharu, Tomohiro Ishii, Tomonobu Hasegawa, Takao Takahashi and Hiroyuki Shimada*

Author Affiliations

Department of Pediatrics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

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Experimental Hematology & Oncology 2012, 1:8  doi:10.1186/2162-3619-1-8

Published: 19 April 2012

Abstract

A patient with acute lymphoblastic leukemia repeatedly developed hypoglycemia during chemotherapy. Comparison of serum glucose trends between chemotherapy with and without L-asparaginase (L-Asp) demonstrated a strong association between L-Asp and hypoglycemia. Critical blood sampling during hypoglycemia indicated hyperinsulinism, suggesting that L-Asp induced hypoglycemia in the patient through inappropriate insulin secretion. Identification of hypoglycemia as an adverse effect will enable clinicians to understand and develop appropriate strategies for L-Asp use in chemotherapy regimens.

Keywords:
L-asparaginase; Fasting hypoglycemia; Hyperinsulinism; Acute lymphoblastic leukemia; Fasting Glucose levels