Exocrine Pancreatic Insufficiency Following Asparaginase-induced Pancreatitis in Pediatric Acute Lymphoblastic Leukemia Patients

Asparaginase is vital for the treatment of pediatric acute lymphoblastic leukemia (ALL), but it can cause numerous adverse effects, including asparaginase-associated pancreatitis (AAP). Exocrine pancreatic insufficiency (EPI) has been reported following pancreatitis but has not yet been reported in the setting of pediatric leukemia. If undiagnosed, EPI can lead to nutritional deterioration. This series describes 3 cases of severe, necrotizing AAP followed by EPI of variable duration. The purpose of this case series is to document these findings and increase awareness about the association between these conditions to facilitate timely identification and intervention, when warranted.