ESPE Abstracts (2016) 86 P-P1-450

Severe Hypertriglyceridemia in Pediatric Oncology Patient

Gema Graua, Nancy Portilloa, Ricardo López Almarazb, Aizpea Echebarriab, Rosa Adánb, Amaia Rodrigueza, Amaia Velaa, Itziar Astigarragab & Itxaso Ricaa


aCruces University Hospital, Pediatric Endocrinology, Barakaldo, Vizcaya, Spain; bCruces University Hospital. Pediatric Oncology, Barakaldo, Vizcaya, Spain


Background: Severe Hypertriglyceridemia (HTG) defined as triglycerides (TG) in blood plasma higher than 1000 mg/dl is a rare condition in childhood. Its causes are classified as primary and secondary and among these last they include pharmacological causes. Steroids associated with some chemotherapy drugs, particularly asparaginase (Asp), are a combination with special risk.

Objective and hypotheses: Describe the evolution of lipids profile in LLA patients, treated with Steroids-Asp.

Method: Retrospective descriptive study of cases of severe HTG in patients with acute lymphoblastic leukemia (ALL) treated in a tertiary hospital in 2010–2015. We have studied the prevalence of this disorder and its characteristics. Patients were treated on the LLA SHOP-2005 or LLA SHEOP-PETHEMA 2013 with an average of 23 dose of intramuscular Steroids-Asp (prednisone 60 mg/m2 per day, or dexamethasone 8 mg/m2 per day)/patient and distributed in three blocks of treatment (induction, intensification or re-induction, and maintenance).

Results: 45 patients were diagnosed with ALL (mean age 5 years old, male/female: 1.5/1). Protocols: ALL SHOP-2005 (49%) and ALL SHEOP-PETHEMA 2013 (51%); 102 estimated blocks with Steroids-Asp administration. It was found severe HTG in four patients with steroid-Asp (prevalence of 4%). The mean age was 7 years. Three were high-risk ALL. No relationship with other medications received was found. The evolution of HTG was adequate regardless of the therapeutic approach. No acute clinical complications. The medium-term evolution was (Table 1):

Table 1. (for abstract P1-P450)
PatientAge (years)TG (mg/dl)TreatmentTG 3 days (mg/dl)TG 1 week (mg/dl)TG 3 months (mg/dl)
A14.5>7.000Bezafibrate (6 mg/kg/día)2,836244NA
B7.76.280Bezafibrate (10 mg/kg/día)32312391
C5.92.200None252340314
D3.53.799None771522171

Conclusion: The Asp and steroids can produce a transient severe HTG. Its management is based on dietary modifications +/− lipid lowering agents, and close monitoring without altering chemotherapy. No serious acute complications observed in any case.

Article tools

My recent searches

No recent searches.

My recently viewed abstracts