儿童B细胞急性淋巴细胞白血病并发培门冬酶相关急性胰腺炎的危险因素分析

doi:10.3969/j.issn.1006-5725.2025.18.010

Abstract

Abstract:

Objective To analyze the clinical characteristics and risk factors of children with B-cell acute lymphoblastic leukemia （B-ALL） who developed acute pancreatitis （AP） after treatment with pegaspargase （PEG-ASP）. Methods A retrospective analysis was conducted on the general data， clinical data， blood routine data， albumin concentration， and cumulative dose of PEG-ASP of 272 children with ALL complicated with AP who received PEG-ASP treatment in the hospital from January 2021 to February 2023. The correlations between gender， age， risk stratification， cumulative dose of pegaspargase， blood routine indicators， albumin concentration and the progression of pancreatitis were analyzed. Results Among the 272 children， the incidence of AP was 8.5% （23/272）. There was no statistically significant correlation between AP and gender， age， body mass index （BMI）， risk stratification， cumulative dose of pegaspargase， hemoglobin concentration， platelet count and monocyte count （P > 0.05）， but there was a significant correlation with white blood cell count， neutrophil count， lymphocyte count， neutrophil/lymphocyte ratio， platelet/lymphocyte ratio and albumin concentration （P < 0.05）. Logistic regression analysis further showed that white blood cell count， neutrophil count， lymphocyte count and albumin concentration were related to the occurrence of PEG-ASP-related AP （P < 0.05）. ROC analysis found that white blood cell count， lymphocyte count and albumin concentration could predict the occurrence of PEG-ASP-related AP. Conclusions White blood cell count， neutrophil count， lymphocyte count and albumin concentration are risk factors for PEG-ASP-related AP in children with B-ALL. Especially， abnormal white blood cell count， lymphocyte count and albumin concentration in blood routine examination can help identify high-risk children with B-ALL complicated with PEG-ASP-related AP at an early stage.

Key words: B-cell, acute lymphoblastic leukemia, peimendonase, acute pancreatitis, risk factors, blood routine

CLC Number:

R733.71

Xiaozhen JIANG,Xiuxian CHEN,Wenming LI. Analysis of risk factors for pegaspargase⁃associated acute pancreatitis in childhood with B⁃cell acute lymphoblastic leukemia[J]. The Journal of Practical Medicine, 2025, 41(18): 2853-2858.

Figures/Tables 3

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References 26

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影响因素	非胰腺炎组（n = 249）	胰腺炎组（n = 23）	χ2/t值	P值
性别/［例（%）］
男	149（59.8）	12（52.2）	0.512	0.474
女	100（40.2）	11（47.8）
年龄/［例（%）］
婴幼儿期	53（21.3）	5（21.7）	1.378	0.502
学龄前	51（20.5）	7（30.5）
学龄期	145（58.2）	11（47.8）
BMI/［例（%）］
正常	98（39.4）	12（52.2）	1.436	0.231
异常	151（60.6）	11（47.8）
危险分层/［例（%）］
标危	63（25.3）	4（17.4）	0.712	0.700
中危	87（34.9）	9（39.1）
高危	99（39.8）	10（43.5）
培门冬酶累计剂量/［例（%）］
≤ 5 000 U/m²	156（62.7）	18（73.9）	1.154	0.283
> 5 000 U/m²	93（37.3）	5（26.1）
白细胞计数/（× 10?·L^-1）	3.80 ± 1.13	2.78 ± 0.90	4.609	< 0.001
血红蛋白浓度/（g/L）	140.4 ± 20.7	141.9 ± 14.9	2.610	0.107
血小板计数/（× 10?·L^-1）	228.0 ± 31.2	221.1 ± 33.9	1.098	0.273
中性粒细胞计数/（× 10?·L^-1）	7.69 ± 2.21	12.53 ± 4.70	41.402	< 0.001
淋巴细胞计数/（× 10?·L^-1）	1.44 ± 0.48	0.91 ± 0.21	14.748	< 0.001
单核细胞计数/（× 10?·L^-1）	1.77 ± 0.32	1.79 ± 0.18	0.325	0.746
NLR	6.75 ± 7.92	14.87 ± 7.44	4.542	0.034
PLR	193.0 ± 83.8	258.6 ± 78.5	3.948	0.001
白蛋白浓度/（g/L）	37.0 ± 4.3	31.6 ± 4.1	6.323	< 0.001

项目	β	P值	调整后OR（95%CI）
白细胞计数	-0.943	0.001	0.390（0.218 ~ 0.698）
淋巴细胞计数	-6.832	0.002	0.001（0.000 ~ 0.420）
白蛋白浓度	-0.351	< 0.001	0.704（0.592 ~ 0.838）

Analysis of risk factors for pegaspargase⁃associated acute pancreatitis in childhood with B⁃cell acute lymphoblastic leukemia

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