**3. The consequences of treatments with antineoplastic drugs**

In children with acute lymphoblastic leukemia (ALL), treated with asparaginase dyslipidemia was frequently observed (Cohen et al., 2010).

A child heterozygote for apolipoprotein E 3/4 and with ALL who received pegasparaginase, presented an important aumentation of serum TG value, which normalized after continuous insulin infusion (Lawson et al., 2011). Another patient with a heterozygote type of familial lipoprotein lipase defect syndrome developed an important increase of serum TG value that was treated by three plasma exchanges with frozen plasma (Nakagawa et al., 2008).

An adult patient with ALL also had an acute pancreatitis because of an important hypertriglyceridemia that appeared after asparaginase administration (Kfoury-Baz et al., 2008), as well as a 10 years old boy who had been previously treated with asparaginase and corticosteroids (Ridola et al., 2008), both successfully treated by plasmapheresis sessions (Kfoury-Baz et al., 2008; Ridola et al., 2008).

In a group of children and adolescent patients recently diagnosed with ALL during treatment a progresive increase of serum CH values to 274+/-124 mg/dl was observed. In this group of patients the average value of TG during tratment was 459+/-526 mg/dl. Two patients had hypertriglyceridemia-related complications: a thrombosis of saggital sinus and an infarct of the left frontal lobe. The observed dyslipidemia disappeared in all children after the asparaginase administration (Cohen et al., 2010).

A prospective study assessed the lipid levels in children with ALL. At diagnosis, there was a significantly low level of total CH and HDL-cholesterol and at the same time a high level of TG. The patients were treated with the ALLIC 2002 protocol (including L-asparaginase), during which the values of total CH and HDL-cholesterol augmented, but they still

In a health investigation conducted on 156,153 subjects, with 5079 incident cancers in men and 4738 cancers in women, and a mean of 10.6 years of survey, there was an inverse association between serum triglyceride (TG) levels and NHL (2). But in the study conducted by Kuliszkiewicz-Janus M et al., the TG value increased in the active disease period in all the

Mihăilă R and al. made a cross-sectional research on all the patients with chronic lymphocytic leukemia (CLL) existing in a county department of hematology and a group of volunteer subjects from the medical staff with no malignant pathology. They found an augmentation of TG values in the patients with CLL (p <0.00001), an argument for a possible link between the MS and chronic lymphoproliferations. Hypercholesterolemia present in the patients with CLL from the above study may have consequences regarding

Nearly all the children with ALL when diagnosed and during chemotherapy revealed a predictable model of serum dyslipidemia that consisted of very low levels of HDLcholesterol, and elevated TG, and low-density lipoprotein cholesterol (LDL-cholesterol), that

In patients with secondary hemophagocytic syndrome an augmentation of TG was observed when diagnosed or during the disease period and TG values decreased when the disease improved under treatment (Okamoto et al., 2009). In patients with aggressive T cell lymphoma, fasting TG level was higher in those with hemophagocytic syndrome group

In children with acute lymphoblastic leukemia (ALL), treated with asparaginase

A child heterozygote for apolipoprotein E 3/4 and with ALL who received pegasparaginase, presented an important aumentation of serum TG value, which normalized after continuous insulin infusion (Lawson et al., 2011). Another patient with a heterozygote type of familial lipoprotein lipase defect syndrome developed an important increase of serum TG value that

An adult patient with ALL also had an acute pancreatitis because of an important hypertriglyceridemia that appeared after asparaginase administration (Kfoury-Baz et al., 2008), as well as a 10 years old boy who had been previously treated with asparaginase and corticosteroids (Ridola et al., 2008), both successfully treated by plasmapheresis sessions

In a group of children and adolescent patients recently diagnosed with ALL during treatment a progresive increase of serum CH values to 274+/-124 mg/dl was observed. In this group of patients the average value of TG during tratment was 459+/-526 mg/dl. Two patients had hypertriglyceridemia-related complications: a thrombosis of saggital sinus and an infarct of the left frontal lobe. The observed dyslipidemia disappeared in all children after

A prospective study assessed the lipid levels in children with ALL. At diagnosis, there was a significantly low level of total CH and HDL-cholesterol and at the same time a high level of TG. The patients were treated with the ALLIC 2002 protocol (including L-asparaginase), during which the values of total CH and HDL-cholesterol augmented, but they still

was treated by three plasma exchanges with frozen plasma (Nakagawa et al., 2008).

hematological malignancies besides NHL (Kuliszkiewicz-Janus et al., 2008).

the multiple drug resistance, subject to further future study. (Mihăilă et al., 2010)

regained normal values during the remission period (Moschovi et al., 2004).

than in the patients who had no hemophagocytic syndrome (Tong et al., 2008).

**3. The consequences of treatments with antineoplastic drugs** 

dyslipidemia was frequently observed (Cohen et al., 2010).

(Kfoury-Baz et al., 2008; Ridola et al., 2008).

the asparaginase administration (Cohen et al., 2010).

remained lower than for the control group. The main serum TG level was significantly higher as compared to that of witnesses (Zalewska-Szewczyk et al., 2008).

A retrospective analysis showed that imatinib mesylate, used for the treatment of patients with chronic myeloid leukemia, led to a diminishing of serum CH and TG values (Franceschino et al., 2008). In a Romanian patient with chronic myeloid leukemia who received usual-dose of imatinib mesylate, a rapid and sustained normalization of serum CH, TG, low- and high-density lipoproteins and glucose values was found (Gologan et al., 2009).

In some types of leukemia it was found that Kit receptor tyrosine kinase is overexpressed in a pathological manner, also that CH depletion was able to prevent Kit-mediated activation of the phosphatidylinositol 3-kinase downstream target Akt, which inhibits cell proliferation (Jahn et al., 2007).

The treatment of cutaneous lymphomas with T cells using bexarotene can produce a serum TG augmentation, as in the three cases reported. The treatment with fenofibrate is recommended, but if adverse effects occure or a statin is needed to reduce hypertriglyceridemia, omega-3 fatty acids may be a therapeutic solution during the bexarotene administration. (Musolino et al., 2009)
