A Case of Effective Post-centrifugal Plasma Filtration for L-asparaginase-induced Severe Hyperlipidemia / 대한수혈학회지

ABSTRACT

Hyperlipidemia has been reported in children with acute lymphoblastic leukemiawho have been treated with L-asparaginase alone or in combination with a steroid. Hyperlipidemia caused by L-asparaginase is usuallyreversible after drug discontinuation, and is rarely associated with severe complications. However, the risk of acute pancreatitis is increased if there is a large increase in triglyceride levels. Prompt correction of hyperlipidemia should be considered to prevent this severe complication. We report a case of successful correction of L-asparaginase-associated severe relapsed hyperlipidemia using post-centrifugal plasma filtration (PCPF), a type of selective plasmapheresis. After 3 sessions of PCPF, the serum concentrations of lipids were markedly reduced. The serum concentration for triglyceridewas reduced to 475 mg/dL from 6,298 mg/dL, the total cholesterol level was reduced to 176 mg/dL from 946 mg/dL, and the level of low-density lipoprotein was reduced to 4 mg/dL from 403 mg/dL. One month later, as determined at the outpatient clinic, the lipid levels were normalized. PCPF was effective for clearing severely increased plasma lipids.