本文報 告 患有前B細胞急性淋巴性白血病的27 歲男性 ，疑似使用 L-asparaginase  引起的肝毒性案例。化學治療用藥包括 doxorubicin、vincristine  及 L-asparaginase，治療 14  天後，病患出現食慾不振，疲憊及肝功能指數上升，疑似 急性肝炎而住院。排除其它可能的致病因素，且依據給藥時間與症狀發生的時序， 停藥後肝功能指數逐漸回復，以 Naranjo 評估其藥物不良反應為可能的及 Roussel Uclaf  Causality  Assessment  Method  評量表，評估其藥物不良反應為極有可能。 L-asparaginase 引起的肝毒性雖不常見，急性淋巴性白血病病患在接受化學治療使 用 L-asparaginase 時，應密切監測其可能引起的肝毒性。
 

We reported a 27-year-old male  with pre-B acute lymphoblastic leukemia suffered from hepatotoxicity associated with L-asparaginase therapy. The case was treated with doxorubicin, vincristine and L-asparaginase. Fourteen days after the chemotherapeutic treatment, the patient complained anorexia, fatigue and the laboratory showed elevated liver enzyme, then he was admitted due to suspected acute hepatitis. After ruling out other possible etiologic factors, we assessed the probability of L-asparaginase-induced hepatotoxicity by observing the time interval between drug administration and the development of  signs and  symptoms and the normalization of abnormal liver function test values gradually after the withhold of  chemotherapy  .  A causality  assessment revealed that an adverse drug reaction was  possible when determined by  the  Naranjo scale and was probable by the Roussel Uclaf Causality Assessment Method score. Although L-asparaginase-induced hepatotoxicity appears to be uncommon, acute lymphoblastic leukemia patients receiving chemotherapy with   L-asparaginase therapy should be considered.