Severe Hypertriglyceridemia in a 6-Year-Old Boy with ALL Relapse: Successfully Treated with Plasmapheresis

Introduction

Asparagin depletion remains an important principle in the therapy of acute lymphoblastic leukemia during primary disease as well as in relapse. Therapy with L-Asparaginase has multiple well known side effects such as allergic reactions, pancreatitis and clotting disorders (Asselin et. al. Blood 1995; 86: 117a; Clavell et al. N Engl J Med 1986; 315: 657–663). It has also been described that the combination of corticosteroids and L-Asparaginase leads to alterations in the lipid profiles in up to two thirds of all treated children (Parsons et al. Blood 1997; 89: 1886–1895). Extreme elevation of triglycerides above 2 000 mg/dl, however, remains a rare side effect.