<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022018000200030</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Pancreatitis aguda como efecto adverso de L-asparginasa en el tratamiento de la leucemia linfocítica aguda]]></article-title>
<article-title xml:lang="en"><![CDATA[Acute pancreatitis as an adverse side effect of L-asparaginase in the treatment of acute lymphoblastic leukemia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cohen-Rosenstock]]></surname>
<given-names><![CDATA[Stephanie]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valverde-Muñoz]]></surname>
<given-names><![CDATA[Kathia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Médico general  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Nacional de Niños Departamento de Hemato-oncología Servicio de Hematología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2018</year>
</pub-date>
<volume>60</volume>
<numero>2</numero>
<fpage>30</fpage>
<lpage>33</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022018000200030&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022018000200030&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022018000200030&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La leucemia linfocítica aguda es la enfermedad oncológica con mayor incidencia en la población pediátrica, tanto a nivel mundial como en Costa Rica. Para su tratamiento requiere protocolos de quimioterapia complejos, lo que representa un reto constante para los médicos, ya que deben equilibrar los riesgos y beneficios del manejo. Es necesario tomar en cuenta los factores de riesgo de cada paciente, el grado de severidad de la enfermedad y los potenciales efectos adversos del tratamiento. A continuación, se reporta un caso de pancreatitis aguda edematosa no biliar, secundaria al uso de L-asparginasa, en un paciente con diagnóstico de leucemia linfocítica aguda, atendido en el Hospital Nacional de Niños &#8220;Dr. Carlos Sáenz Herrera&#8221;. El paciente, quien se encontraba cumpliendo el régimen poliquimioterapeútico AHOPCA 2008, presentó clínica sugestiva de pancreatitis aguda en el día 50 de este, por lo que se decidió no colocar la quimioterapia indicada e inmediatamente se trasladó al Servicio de Emergencias. El cuadro clínico estaba asociado a laboratorios y ultrasonido anormales, por lo que fue tratado interdisciplinariamente y su pronóstico fue favorable; actualmente continúa con tratamiendo quimioterapeútico, como fue indicado.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The acute lymphocytic leukemia is the oncological disease with the highest incidence in the pediatric population both worldwide and in Costa Rica. It requires complex chemotherapy protocols, which confers a constant challenge on physicians to balance the risks and benefits of management. Therefore, it is necessary to take into account the risk factors of each patient, the degree of severity of the disease and the potential adverse effects of the treatment. A case report is presented with an acute non-biliary edematous pancreatitis, secondary to the use of L-asparaginase in a patient diagnosed with acute lymphocytic leukemia, seen at the National Children&#8217;s Hospital &#8220;Dr. Carlos Sáenz Herrera&#8221;. The patient who was started on the AHOPCA 2008 polychemotherapy regimen presented symptoms suggestive of acute pancreatitis on the day 50 of the same, so it was decided not to apply the indicated chemotherapy and transfer the patient to the Emergency Room. The clinical picture was associated with abnormal laboratories and ultrasound, so it was immediately treated interdisciplinarily, which is why its prognosis was favorable and currently he continues with chemotherapy treatment as indicated.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[leucemia linfocítica aguda]]></kwd>
<kwd lng="es"><![CDATA[L-asparginasa]]></kwd>
<kwd lng="es"><![CDATA[pancreatitis]]></kwd>
<kwd lng="en"><![CDATA[acute lymphocytic leukemia]]></kwd>
<kwd lng="en"><![CDATA[L-asparaginase]]></kwd>
<kwd lng="en"><![CDATA[pancreatitis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<collab>M. Salud, Dirección Vigilancia de la Salud, Unidad de Seguimiento de Indicadores de Salud</collab>
<source><![CDATA[Registro Nacional de Tumores]]></source>
<year>2017</year>
<page-range>6</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ben Tanfous]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sharif-Askari]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Ceppi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Laaribi]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Gagne]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Rousseau]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Polymorphisms of asparaginase pathway and asparaginase-related complications in children with acute lymphoblastic leukemia]]></article-title>
<source><![CDATA[Clin Cancer Res]]></source>
<year>2015</year>
<volume>15</volume>
<numero>21</numero>
<issue>21</issue>
<page-range>329-34</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Navarrete]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Rossi]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Brivio]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Carrillo]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Bonilla]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Vasquez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology of childhood leukemia in Costa Rica. Treatment outcome DFW-II Protocol]]></article-title>
<source><![CDATA[Pediatr Blood Cancer]]></source>
<year>2007</year>
<volume>49</volume>
<numero>464</numero>
<issue>464</issue>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodriguez-Galindo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Friedrich]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Alcasabas]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Antillon]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Banavali]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Castillo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Toward the cure of all Children with cancer through collaborative efforts: pediatric oncology as a global challenge]]></article-title>
<source><![CDATA[J Clin Oncol]]></source>
<year>2015</year>
<volume>20</volume>
<numero>33</numero>
<issue>33</issue>
<page-range>3065-73</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van den Berg]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Leukemia and Lymphoma. Asparaginase revisited]]></article-title>
<source><![CDATA[Leuk Lymphoma]]></source>
<year>2011</year>
<volume>52</volume>
<page-range>168-78</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Flores-Calderón]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Exiga-Gonzaléz]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Morán-Villota]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Martín-Trejo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Yamamoto-Nagano]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute pancreatitis in children wjth acute lymphoblastic leukemia treated with L-Asparaginase]]></article-title>
<source><![CDATA[J Pediatr Hematol Oncol]]></source>
<year>2009</year>
<volume>31</volume>
<page-range>790-3</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nicklas Sundell]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Boström]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Edenholm]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Abrahamsson]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of neutropenic enterocolitis in children with cancer]]></article-title>
<source><![CDATA[Acta Paediatr]]></source>
<year>2012</year>
<volume>101</volume>
<page-range>308-12</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Treepongkaruna]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Thongpak]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Pakakasama]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Pienvichit]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Sirachainan]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Hongeng]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute Pancreatitis in children with acute lymphoblastic leukemia after chemotherapy]]></article-title>
<source><![CDATA[J Pediatr Hematol Oncol]]></source>
<year>2009</year>
<volume>31</volume>
<page-range>812-5</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abajj]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Gagné]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Spinella]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Ceppi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Laverdière]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Whole-exome sequencing identified genetic risk factors for asparaginase-related complications in childhood ALL patients]]></article-title>
<source><![CDATA[Oncotarget]]></source>
<year>2017</year>
<volume>4</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>43752-67</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silverman]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
<name>
<surname><![CDATA[Gelber]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Dalton]]></surname>
<given-names><![CDATA[VK]]></given-names>
</name>
<name>
<surname><![CDATA[Asselin]]></surname>
<given-names><![CDATA[BL]]></given-names>
</name>
<name>
<surname><![CDATA[Barr]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Clavell]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91-01]]></article-title>
<source><![CDATA[Blood]]></source>
<year>2001</year>
<volume>1</volume>
<numero>97</numero>
<issue>97</issue>
<page-range>1211-8</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pession]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Valsecchi]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Masera]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Kamps]]></surname>
<given-names><![CDATA[WA]]></given-names>
</name>
<name>
<surname><![CDATA[Magyarosy]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Rizzari]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Long-term results of a randomized trial on extended use of high dose L-asparaginase for standard risk childhood acute lymphoblastic leukemia]]></article-title>
<source><![CDATA[J Clin Oncol]]></source>
<year>2005</year>
<volume>1</volume>
<numero>23</numero>
<issue>23</issue>
<page-range>7161-7</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kearney]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Dahlberg]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Levy]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
<name>
<surname><![CDATA[Voss]]></surname>
<given-names><![CDATA[SD]]></given-names>
</name>
<name>
<surname><![CDATA[Sallan]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Silverman]]></surname>
<given-names><![CDATA[LB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical course and outcome in children with acute lymphoblastic leukemia and asparaginase-associated pancreatitis]]></article-title>
<source><![CDATA[Pediatr Blood Cancer]]></source>
<year>2009</year>
<volume>53</volume>
<page-range>162-7</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wolthers]]></surname>
<given-names><![CDATA[BO]]></given-names>
</name>
<name>
<surname><![CDATA[Frandsen]]></surname>
<given-names><![CDATA[TL]]></given-names>
</name>
<name>
<surname><![CDATA[Baruchel]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Attarbaschi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Barzilai]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Colombini]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Asparaginase-associated pancreatitis in childhood acute lymphoblastic leukaemia: an observational Ponte di Legno Toxicity Working Group study]]></article-title>
<source><![CDATA[Lancet Oncol]]></source>
<year>2017</year>
<volume>18</volume>
<page-range>1238-48</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sakaguchi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Higa]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Suzuki]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Fujimura]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Shimizu]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prophylactic use of octreotide for asparaginase-induced acute pancreatitis]]></article-title>
<source><![CDATA[Int J Hematol]]></source>
<year>2017</year>
<volume>106</volume>
<page-range>266-8</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[SF]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Peng]]></surname>
<given-names><![CDATA[CT]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[KH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Octreotide Therapy in Asparaginase-Associated Pancreatitis in Childhood Acute Lymphoblastic Leukemia]]></article-title>
<source><![CDATA[Pediatr Blood Cancer]]></source>
<year>2008</year>
<volume>51</volume>
<page-range>824-5</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
