In a patient receiving asparaginase as part of ALL induction therapy, which adverse effect is most commonly associated?

• A. Nephrotoxicity
• B. Cardiotoxicity
• C. Pancreatitis
• D. Neurotoxicity

Answer: (C)

Asparaginase often causes pancreatitis, making it the most common adverse effect seen during ALL induction. The drug depletes circulating asparagine to target leukemic cells, but this disruption can also affect the pancreas, leading to abdominal pain with elevated amylase or lipase and sometimes clinically significant pancreatitis that may require holding the drug. While other toxicities can occur with asparaginase, such as coagulopathy or hepatotoxicity, nephrotoxicity, cardiotoxicity, and neurotoxicity are not typical or as common. Recognizing pancreatitis early is important because it guides management, including possible interruption of therapy and supportive care.