Use of Levocarnitine to Reduce Asparaginase Hepatotoxicity in Patients With Acute Lymphoblastic Leukemia
Status:
Not yet recruiting
Trial end date:
2023-12-31
Target enrollment:
Participant gender:
Summary
Acute lymphoblastic leukemia (ALL) is the most common cancer seen in pediatric oncology. The
necessary chemotherapy for pediatric and adolescent and young adult (AYA) patients with ALL
includes steroids, anthracyclines, asparaginase, and vincristine. One of the most hepatotoxic
chemotherapy agents is asparaginase, with treatment-associated hepatotoxicity (TAH) observed
in up to 60% of patients. The frequency of TAH is increased in overweight or obese patients
of Latino heritage. Carnitine is a naturally-derived compound that is produced in the liver
and kidneys; it is found in certain foods, such as meat, poultry, fish, and some dairy
products. Endogenous carnitine transports long-chain fatty acids into the mitochondria, where
they are oxidized to produce energy, and acts as scavengers of oxygen free radicals. Thus,
carnitine can reduce oxidative stress and modulate inflammatory response. Levocarnitine is a
supplement form of carnitine used typically in the care and management of patients with
carnitine deficiency. Pediatric and AYAs with ALL will be given oral levocarnitine as a
supplement during their initial phases of treatment, when the most hepatotoxic agents are
administered, to determine if the incidence of liver toxicity can be reduced or eliminated.