The Effect of Chemotherapy Induction Therapy on the Pancreas in Patients with Acute Lymphoblastic Leukemia

Abstract

Background. The effect of chemotherapy induction on the pancreatic in patients with acute lymphoblastic leukemia is not described in Ethiopia. The study determined the chemotherapy drug-induced pancreatitis in patients with acute lymphoblastic leukemia. Method. A preexperimental study (pretest and posttests) was conducted in forty patients with acute lymphoblastic leukemia. For some skewed data, a log transformation was computed. The back transformation was then calculated. Descriptive statistics and a mixed-model ANOVA were used to analyze the data. A post hoc Bonferroni test was used. A $p$ value < 0.05 was declared statistically significant. Results. In this study, no clinically significant acute pancreatitis occurred. Elevated amylase and lipase levels, indicating grade 2 acute pancreatitis, were observed in 25% and 17.5% of patients, respectively. Amylase enzyme levels in children differed significantly from preinduction to the second week of induction ( $p=0.001$ ) and fourth week of induction ( $p=0.001$ ), as well as between the second and fourth weeks of induction ( $p=0.033$ ), but adults’ amylase enzyme levels did not differ significantly ( $p=0.2$ ). Lipase levels in adults are nearly identical in all three measures, implying that there is no statistically significant difference ( $p=0.775$ ). However, the level of lipase enzyme in children was significantly higher from baseline to two and four weeks of induction ( $p=0.007$ ) but not between two and four weeks of induction ( $p=0.129$ ). Conclusion. Clinically significant acute pancreatitis did not occur, but patients experienced mild (grade 2) acute pancreatitis. Amylase and lipase enzymes responded significantly to chemotherapy induction in children. Chemotherapy drugs should be given without altering pancreatic enzymes, specifically in children.