Which monitoring parameter is commonly checked to detect pancreatitis risk during L‑asparaginase therapy?

• A. Amylase/lipase
• B. Bilirubin
• C. Coagulation studies
• D. Creatinine clearance

Answer: (A)

Pancreatitis is a known toxicity of L-asparaginase, so monitoring pancreatic enzymes helps catch it early. Serum amylase and lipase rise when the pancreas is inflamed, with lipase offering greater specificity for pancreatitis. Regularly measuring these enzymes during therapy allows detection of pancreatitis risk, even before obvious symptoms, and guides timely management such as holding the drug if levels rise significantly or if abdominal symptoms appear. Other tests like bilirubin, coagulation studies, and creatinine clearance reflect liver function, clotting, or kidney function and are important for overall safety, but they do not specifically monitor for pancreatitis risk.