Aim:

To explore whether the presence of dosing errors with L-asparaginase is associated with the occurrence of L-asparaginase-associated pancreatitis (PAA) during remission induction therapy in pediatric patients with acute lymphoblastic leukemia (ALL).

Methodology:

A secondary analysis of a retrospective cohort was performed in patients with ALL who received induction treatment between 2015 and 2017. An absolute deviation greater than 10% of the required dose was considered a dosage error. PAA cases were captured from the files. Relative risks (RR) with confidence intervals for dosage error, underdose, and overdose were calculated.

Results:

181 patients were included. 5 cases of PAA (1.1%) were documented and 18 (9.9%) patients had dosing errors with L-asparaginase prior to PAA. A statistically significant association was observed between the presence of dosage errors (RR=6.04; 1.08-33.77) and overdose (RR=10.67; 1.33-85.46).

Conclusions:

a possible association between dosage errors with L-asparaginase and PAA was observed. However, studies with a statistical approach and an adjustment for confounding variables are required.