A Teenaged Patient with Severe Asparaginase-Induced Hypertriglyceridemia Safely Re-Challenged During Primary and Relapse Therapy for Acute Lymphoblastic Leukemia

Asparaginase is a highly effective drug in the management of acute lymphoblastic leukemia (ALL), but can cause abnormalities in lipid metabolism leading to hypercholesterolemia and hypertriglyceridemia. This may result in serious consequences, such as pancreatitis and hyperviscosity syndrome. Currently, there is no consensus regarding re-challenge with further doses of asparaginase if this complication occurs. We report the case of a teenaged male patient with ALL treated with asparaginase who presented with extreme hyperlipidemia during induction therapy. He was managed conservatively with complete resolution of lipid abnormalities and was re-challenged during both primary and relapse therapy without a recurrence of hyperlipidemia