A 6-year-old boy on multi-agent induction chemotherapy for acute lymphoblastic leukemia develops severe abdominal pain radiating to the back with elevated serum amylase and lipase. Which drug in his regimen is the most likely cause?
- A L-asparaginase ✓
- B Vincristine
- C Prednisolone
- D Methotrexate
Correct answer: A. L-asparaginase
Explanation
L-asparaginase depletes circulating asparagine and is well known for pancreatitis as a characteristic adverse effect, along with hypersensitivity reactions, coagulation abnormalities, hepatic dysfunction and hyperglycemia. Vincristine causes peripheral neuropathy, prednisolone causes hyperglycemia and immunosuppression, and methotrexate causes mucositis and myelosuppression, so pancreatitis localizes the answer to L-asparaginase.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.