Pegaspargase induced multiple organ failure with acute lymphoblastic leukemia: A case report

Abstract

BACKGROUND

The introduction of pegaspargase has greatly advanced the treatment of acute lymphoblastic leukemia (ALL). In the literature, only one case of pegaspargase-induced multiple organ failure has been reported, and the patient died due to multiple organ failure.

CASE SUMMARY

Herein, we present a rare case of a 40-year-old man with ALL who developed multiple organ failure after treatment with pegaspargase. The patient had two rare phenomena reflecting poor prognosis, including the discrepancy between clinical manifestations and liver function and persistently low alpha-fetoprotein (AFP) levels from subacute liver failure. However, the patient was successfully treated using a multidisciplinary team approach.

CONCLUSION

This is the first case report of successful treatment of pegaspargase-induced multiple organ failure. The findings emphasize the importance of a multidisciplinary team approach in treating pegaspargase-induced multiple organ failure.

Keywords: Pegaspargase; Multiple organ failure; Acute lymphoblastic leukemia; Liver failure; Case report

Core Tip: We reported a rare patient with acute lymphoblastic leukemia, who suffered from multiple organ failure following the first application of pegaspargase. To date, only one patient has been reported and the patient died due to multiple organ failure in the reviewed word literature. In the article, although the patient had two rare phenomena reflecting poor prognosis, the patient was the first case of successful treatment. Two rare phenomena including inconformity between clinical manifestation and liver function, and persistent low AFP concentrations from subacute liver failure patients will be discussed in this patient.