Abstract
During the treatment with E. coli L-asparaginase in one adult and one child patient with acute myeloid leukemia, severe cerebral signs of toxicity, such as apathy, lethargy, confusion, and coma have been observed.
The necropsy findings of the brain are bilateral demyelating lesions of the cerebellum in the adult case and of the thalamus in the child patient.
Liver toxicity has been evident both in terms of function tests—serum bilirubin, SGOT, SGPT, LDH, and morphological changes—fatty metamorphosis and necrosis.
A correlation between these abnormalities and elevated blood ammonia levels has been suggested, and a resemblance of these changes to the pseudoulegyric type of hepatocerebral disease has been discussed.
L-asparaginase as a last choice of antileukemic drugs should be used most carefully with a countermeasure for its side effects.
