Frequency of Asparaginase-Associated Pancreatitis in Patients Presenting with Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma

Background: L-asparaginase is a vital component of chemotherapy protocols for acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL), significantly improving remission and survival rates. However, its use is associated with serious adverse effects, including asparaginase-associated pancreatitis (AAP), which can interrupt treatment and increase morbidity. The reported incidence of AAP varies from 2.5% to 16% globally, but local data among young adults are limited. This study aimed to determine the frequency of AAP in young adults diagnosed with ALL and LBL at a tertiary care cancer hospital in Pakistan. Methods: A cross-sectional study was conducted at the Department of Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, over six months following synopsis approval. One hundred patients aged 16–25 years with confirmed diagnoses of ALL or LBL were enrolled through non-probability consecutive sampling. Results: The mean age of participants was 20.6 ± 2.8 years, with 55% males and 45% females. Eighty-five percent were diagnosed with ALL and 15% with LBL. Asparaginase-associated pancreatitis was identified in seven patients (7%). No significant associations were observed between AAP and age, gender, WBC count, disease duration, or duration of asparaginase therapy (p > 0.05). Overall mortality was 5%, including one patient with pancreatitis. Conclusion: The frequency of asparaginase-associated pancreatitis in young adults with ALL and LBL was 7%, aligning with international data. Routine biochemical and radiological monitoring during chemotherapy is recommended for early detection and timely management to reduce treatment-related morbidity.