Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.5.1.1 (asparaginase)
 2,695 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Plasma lipids and apolipoproteins were determined in 19 children with acute lymphoblastic leukemia (ALL) or malignant lymphoma (ML) who were treated by L-asparaginase with prednisolone and vincristine. Extreme hypertriglyceridemia, i.e., over 10,000 mg/l of the maximum serum triglyceride concentration, was induced in 8 patients; these concentrations were not over 10,000 mg/l in the remaining 11 patients. The possibility was raised that the apolipoprotein E (apoE) isoform apoE4 (epsilon 4) participated in the induction of extreme hypertriglyceridemia, since the frequency of the apoE4/E3 phenotype in the patients with extreme hypertriglyceridemia was higher compared to those in the patients without extreme hypertriglyceridemia and control subjects (n = 248). The acute and severe hypertriglyceridemia was induced at 8 to 14 days after the end of the L-asparaginase therapy, with an earlier remarkable increase in the apoCIII/apoCII ratio and an extreme decrease of fibrinogen concentrations (a marker of the protein productivity of the liver). It is well known that apoCII and apoCIII have possible functions as an activator and an inhibitor of lipoprotein lipase (LPL), respectively. The extreme increase in the apoCIII/apoCII ratio could be one of the reasons for the accumulation of triglyceride-rich lipoproteins in plasma.
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PMID:Characterization of hypertriglyceridemia induced by L-asparaginase therapy for acute lymphoblastic leukemia and malignant lymphoma. 930 74

We describe a pediatric patient with acute leukemia who developed an uncommon but significant metabolic consequence of pegaspargase therapy-severe hypertriglyceridemia (hyperTG). We also relate our experience with continuous insulin infusion treatment for pegaspargase-induced hyperTG. This treatment approach led to a decrease in triglycerides from 4640 mg/dL on admission to 522 mg/dL at discharge 9 days later. Genetic testing revealed that our patient was an apolipoprotein E 3/4 heterozygote. Our review of the literature suggests that apolipoprotein E polymorphism may influence the development of hyperlipidemia in acute lymphoblastic leukemia patients receiving asparaginase therapy and may identify patients at high risk for developing asparaginase-induced hyperTG.
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PMID:Insulin infusion to treat severe hypertriglyceridemia associated with pegaspargase therapy: a case report. 2134 48