Korean J Pediatr Hematol Oncol.  1999 Apr;6(1):146-150.

Four Cases of Acute Parotitis in Acute Lymphoblastic Leukemia Patients Developed during Induction Chemotherapy Including L-Asparaginase

• Lee JH
• Lee JA
• Han HJ
• Choi Y
• Choi HS
• Shin HY
• Ahn HS

Abstract

L-asparaginase is an essential chemotherapeutic agent in the treatment of the acute lymphoblastic leukemia or non-Hodgkin lymphoma with its unique mechanism of action. It has many toxic effects involving multiple organs. The acute parotitis associated with L-asparaginase has been rarely reported. In this report, acute parotitis developed in the 4 acute lymphoblastic leukemia patients who were treated with the induction chemotherapy regimen including L-asparaginase. Mumps was excluded in 3 patients and the evidence of coexisting pancreatitis was observed in 2 patients. The parotid ultrasonography revealed diffuse enlargement in all patients. The symptoms were spontaneously resolved with no specific treatment, and in all cases there was no recurrence of the same disease with later maintenance chemotherapy including L-asparaginase. The possible mechanism of the acute parotitis is not yet clearly understood. But considering its histologic similarity with the pancreas, the depletion of L-asparagine may damage the acinar cells of parotid gland. The acute parotitis is not a well-known side effect of L-asparaginase but it needs to be promptly recognized in order to consider the discontinuation of the L-asparaginase and to exclude any viral infection requiring isolation.

Keyword

Parotitis; L-asparaginase; Childhood ALL

MeSH Terms

Acinar Cells
Asparagine
Humans
Induction Chemotherapy*
Lymphoma, Non-Hodgkin
Maintenance Chemotherapy
Mumps
Pancreas
Pancreatitis
Parotid Gland
Parotitis*
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Recurrence
Ultrasonography
Asparagine