The ASP-induced hepatotoxicity remains one of the major concerns related to ASP treatment. It is reported in 30–60% of patients and can range from a mild increase in bilirubin and/or transaminase to fulminant hepatic failure, resulting in significant morbidity and delays, discontinuations or reductions in the planned dose of chemotherapy [6], [7], [8]. Risk factors for liver toxicity are older age, previous liver disease, steatosis, overweight or obesity [7]. Peg-ASP was thought to be more hepatotoxic than the native form due to its more profound and prolonged action, but Christ et al. [8] reported no differences in terms of toxicity between the two formulations. The mechanism of this toxicity is largely unknown, but it is thought to be related to a decreased protein synthesis or a mitochondrial dysfunction [9].
Levocarnitine supplementation for asparaginase-induced hepatotoxicity in adult acute lymphoblastic leukemia patients: A multicenter observational study of the campus all group
Bonifacio, Massimiliano;
2022-01-01
Abstract
The ASP-induced hepatotoxicity remains one of the major concerns related to ASP treatment. It is reported in 30–60% of patients and can range from a mild increase in bilirubin and/or transaminase to fulminant hepatic failure, resulting in significant morbidity and delays, discontinuations or reductions in the planned dose of chemotherapy [6], [7], [8]. Risk factors for liver toxicity are older age, previous liver disease, steatosis, overweight or obesity [7]. Peg-ASP was thought to be more hepatotoxic than the native form due to its more profound and prolonged action, but Christ et al. [8] reported no differences in terms of toxicity between the two formulations. The mechanism of this toxicity is largely unknown, but it is thought to be related to a decreased protein synthesis or a mitochondrial dysfunction [9].
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