Levocarnitine and vitamin B complex for the treatment of pegaspargase-induced hepatotoxicity: A case report and review of the literature

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
Alison BlackmanNicholas Forcello

Abstract

Asparaginase is a chemotherapeutic agent that is commonly used in combination with other medications for the treatment of acute lymphoblastic leukemia. An adverse effect of asparaginase includes hepatotoxicity, which can lead to severe liver failure and death. Several reports have documented successful treatment of asparaginase-induced hepatotoxicity using levocarnitine (l-carnitine) and vitamin B complex. Herein, we report a patient with acute lymphoblastic leukemia that experienced acute liver injury following pegaspargase administration. Our patient was successfully treated with l-carnitine and vitamin B complex for 8 days and achieved recovery of hepatic function. Furthermore, we review the current literature and provide a recommendation on a regimen that can be used as an option for the treatment of asparaginase-induced hepatic injury.

References

Sep 25, 1999·Southern Medical Journal·Y K KeungE Cobos
Oct 3, 2003·Seminars in Liver Disease·Sunati Sahoo, John Hart
Oct 13, 2015·Leukemia & Lymphoma·Nobuko Hijiya, Inge M van der Sluis
Feb 4, 2016·Acta Haematologica·Ruham Alshiekh-Nasany, Dan Douer
Jul 22, 2016·Journal of Pharmacology & Pharmacotherapeutics·Rachel A EglerYousif Matloub

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Citations

Mar 29, 2019·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Najeebah A BadeAshkan Emadi
Apr 11, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Sumit GuptaMeenakshi Devidas
Aug 14, 2020·Leukemia & Lymphoma·Elena TrangVinod Pullarkat
Aug 9, 2019·Hepatology International·Natasha KamalUNKNOWN Drug-Induced Liver Injury Network
Oct 18, 2019·ACG Case Reports Journal·Ishani ShahJustin A Reynolds
Oct 11, 2020·Science Advances·Rohiverth GuarecucoKıvanç Birsoy
Dec 2, 2020·Seminars in Hematology·Cecilie Utke Rank, Kjeld Schmiegelow

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