Abstract

L-ASPARAGINASE-INDUCED LIVER INJURY MANAGED WITH LCARNITINE AND VITAMIN B INFUSION

Christy Merin Mathew*, Minna Sara Philip, Dr. Bobby Abraham and Dr. Chepsy C. Philip

.

Abstract

Asparaginase is an important drug in the chemotherapeutic management of acute lymphoblastic leukemia (ALL). It occasionally causes liver injury by its toxic effects in the mitochondria of hepatocytes. Levocarnitine is a mitochondrial co-factor that can potentially ameliorate the mitochondrial toxicity of asparaginase.[1, 4, 5] We present the case of a 46-year-old gentleman with T cell ALL, who developed asparaginase-induced liver injury after starting intravenous L-asparaginase-based chemotherapy. The patient was treated with the combination of L-carnitine and vitamin B complex for the hepatotoxicity, which resulted in normalization of transaminitis. This case highlights the occurrence of L-asparaginase chemotherapy -induced liver injury as well as the role of L-carnitine and vitamin B complex as treatment.

Keywords: Acute lymphocytic leukemia; Asparaginase; Chemotherapy-induced liver injury; L-carnitine