Question
A 5-year-old boy, started on induction chemotherapy for acute lymphoblastic leukemia, develops acute abdominal pain on day 14 of chemotherapy. On abdominal examination, there is marked abdominal tenderness and Cullen's sign is positive. The most likely chemotherapeutic drug which can be implicated is:
This question was previously asked in
UPSC CMS 2026 Surgery, Gynaecology & Obstetrics, and PSM Question Paper (02-Aug-2026)
The correct answer is
L-asparaginase
L-asparaginase is a well-known cause of acute pancreatitis in children undergoing ALL induction chemotherapy; Cullen's sign (periumbilical ecchymosis) with abdominal tenderness suggests hemorrhagic pancreatitis, a recognized L-asparaginase toxicity, unlike vincristine, daunorubicin, or methotrexate.
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