Transient Diabetes Induced by L-Asparaginase

Background: Although hyperglycaemia is one of the known side effects of L-asparaginase, its contribution to the development of diabetic ketoacidosis (DKA) is less well known in the literature. Asparaginase is an essential component of treatment protocols for acute lymphoblastic leukaemia (ALL) in combination with other chemotherapeutic drugs. On further evaluation, she was found to have high anion gap metabolic acidosis, hyperglycaemia and ketonuria. In recent decades, the use of these chemotherapeutic agents has led to a decrease in mortality and disease-free survival in ALL. L-asparaginase is one of the chemotherapy protocols used in the treatment of acute lymphoblastic leukaemia (ALL) and can induce hyperglycaemia which is aggravated by the concomitant use of corticosteroids. We report the observation of a 14-year-old girl treated with chemotherapy (GFA LAL protocol) who developed transient diabetes following the use of L-asparaginase. She was treated at the Donka paediatric haemato-oncology unit by a multidisciplinary team including a paediatric oncologist, a psychologist and a diabetologist. The aim of this study was to highlight blood glucose monitoring before and after the use of asparaginase in acute lymphoblastic leukaemia. Conclusion: We conclude that the occurrence of ketoacidosis following the use of asparaginase is a rare event. We recommend close monitoring of blood glucose levels for hyperglycaemia in patients with ALL receiving L-asparaginase.