{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T18:40:33Z","timestamp":1763059233535,"version":"3.41.2"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T00:00:00Z","timestamp":1728345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007836","name":"Shanghai Municipal Key Laboratory of Intelligent Information Processing, Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["\u7f16\u53f7\uff1a22Y11921800"],"award-info":[{"award-number":["\u7f16\u53f7\uff1a22Y11921800"]}],"id":[{"id":"10.13039\/100007836","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Asparaginase-associated pancreatitis (AAP) is a major challenge for continuing asparaginase therapy. We aimed to investigate the acute and long-term complications and survival rates related to first and second AAP episodes in Chinese children with haematological malignancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analysed clinical data of children with pancreatitis who received asparaginase chemotherapy for acute lymphoblastic leukaemia (ALL), acute mixed cell leukaemia, and non-Hodgkin\u2019s lymphoma at Shanghai Children\u2019s Medical Center from November 2013 to November 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 76 children included in the study, 12 had local complications (15.79%), with no deaths recorded. Systemic complications manifested in 28 patients (36.84%), resulting in 3 deaths (3.95%). Four patients (5.26%) developed long-term complications (chronic pancreatitis or insulin-dependent diabetes mellitus). No significant differences in local or long-term complications were recorded between children in the asparaginase re-exposed (n=39) and non-re-exposed (n=45) groups. Among the re-exposed patients, eight (25.81%) experienced a second attack without fatalities or complications. Survival analysis of intermediate- to high-risk patients revealed a significantly higher event-free survival (EFS) rate for the re-exposed group than for the non-re-exposed group. The second AAP episode\u2019s occurrence and severity had no relation to the first AAP episode\u2019s severity, and the second AAP episode was significantly less severe than the first (<jats:italic>p<\/jats:italic>&amp;lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The second AAP episode\u2019s occurrence is unrelated to the first AAP episode\u2019s severity, and the second AAP episode\u2019s severity is significantly lower than that of the first. Further, asparaginase therapy could improve EFS in children with intermediate and high-risk ALL.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1472049","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T05:10:25Z","timestamp":1728364225000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of asparaginase-associated pancreatitis in children with haematological tumours"],"prefix":"10.3389","volume":"14","author":[{"given":"Hui-jiao","family":"Tang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-cheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-ting","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu-hong","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing-qing","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao-hui","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"25","DOI":"10.2147\/BLCTT.S245210","article-title":"Clinical utility of pegaspargase in children, adolescents and young adult patients with acute lymphoblastic leukemia: A review","volume":"11","author":"Bender","year":"2021","journal-title":"Blood Lymphat Cancer"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4419","DOI":"10.3390\/jcm10194419","article-title":"L-asparaginase toxicity in the treatment of children and adolescents with acute lymphoblastic leukemia","volume":"10","author":"Schmidt","year":"2021","journal-title":"J Clin Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020006583","article-title":"Relapse risk following truncation of pegylated asparaginase in childhood acute lymphoblastic leukemia","volume":"137","author":"Gottschalk H\u00f8jfeldt","year":"2021","journal-title":"Blood"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.11.411","article-title":"Long-term results of a randomized trial on extended use of high dose l-asparaginase for standard risk childhood acute lymphoblastic leukemia","volume":"23","author":"Pession","year":"2005","journal-title":"J Clin Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.5.1211","article-title":"Improved outcome for children with acute lymphoblastic leukemia: Results of dana-farber consortium protocol 91-01","volume":"97","author":"Silverman","year":"2001","journal-title":"Blood"},{"key":"B6","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1111\/bjh.2012.159.issue-1","article-title":"Asparaginase-associated pancreatitis in children","volume":"159","author":"Raja","year":"2012","journal-title":"Br J Haematol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30610-1","article-title":"Questions on asparaginase-associated pancreatitis","volume":"18","author":"Pemmaraju","year":"2017","journal-title":"Lancet Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30424-2","article-title":"Asparaginase-associated pancreatitis in childhood acute lymphoblastic leukaemia: An observational ponte di legno toxicity working group study","volume":"18","author":"Wolthers","year":"2017","journal-title":"Lancet Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-643544","article-title":"The 2016 revision to the world health organization classification of myeloid neoplasms and acute leukemia","volume":"127","author":"Arber","year":"2016","journal-title":"Blood"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30035-3","article-title":"Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: A delphi consensus","volume":"17","author":"Schmiegelow","year":"2016","journal-title":"Lancet Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30528","article-title":"Long-term effects of asparaginase-associated pancreatitis","volume":"70","author":"Skipper","year":"2023","journal-title":"Pediatr Blood Cancer"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302779","article-title":"Classification of acute pancreatitis\u20132012: Revision of the atlanta classification and definitions by international consensus","volume":"62","author":"Banks","year":"2013","journal-title":"Gut"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v15.i9.1879","article-title":"Surgical decompression for the management of abdominal compartment syndrome with severe acute pancreatitis: A narrative review","volume":"15","author":"Nasa","year":"2023","journal-title":"World J Gastrointest Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1164\/rccm.202303-0558WS","article-title":"A new global definition of acute respiratory distress syndrome","volume":"209","author":"Matthay","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"67","DOI":"10.20471\/acc.2022.61.s1.11","article-title":"Sepsis definition: What's new in the treatment guidelines","volume":"61","author":"Srzi\u0107","year":"2022","journal-title":"Acta Clin Croat"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22076","article-title":"Clinical course and outcome in children with acute lymphoblastic leukemia and asparaginase-associated pancreatitis","volume":"53","author":"Kearney","year":"2009","journal-title":"Pediatr Blood Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003334","article-title":"Clinical characteristics and short-term outcomes of children with asparaginase-associated pancreatitis","volume":"74","author":"Mauney","year":"2022","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.14223","article-title":"Acute pancreatitis in pediatric patients: Demographics, etiology, and diagnostic imaging","volume":"206","author":"Restrepo","year":"2016","journal-title":"AJR Am J Roentgenol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.5812","article-title":"Clinical and genetic risk factors for acute pancreatitis in patients with acute lymphoblastic leukemia","volume":"34","author":"Liu","year":"2016","journal-title":"J Clin Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.2014.165.issue-1","article-title":"Asparaginase-associated pancreatitis in children with acute lymphoblastic leukaemia in the nopho all2008 protocol","volume":"165","author":"Raja","year":"2014","journal-title":"Br J Haematol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02208","article-title":"Asparaginase-associated pancreatitis in acute lymphoblastic leukemia: Results from the nopho all2008 treatment of patients 1-45 years of age","volume":"38","author":"Rank","year":"2020","journal-title":"J Clin Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.03024","article-title":"Impact of asparaginase discontinuation on outcome in childhood acute lymphoblastic leukemia: A report from the children's oncology group","volume":"38","author":"Gupta","year":"2020","journal-title":"J Clin Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2024.1472049\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T05:10:26Z","timestamp":1728364226000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2024.1472049\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,8]]},"references-count":22,"alternative-id":["10.3389\/fonc.2024.1472049"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2024.1472049","relation":{},"ISSN":["2234-943X"],"issn-type":[{"type":"electronic","value":"2234-943X"}],"subject":[],"published":{"date-parts":[[2024,10,8]]},"article-number":"1472049"}}