ASPG and acute lymphoblastic leukemia: Hypoalbuminemia is often present when starting HDMTX infusions in children with ALL, probably as a side effect of asparaginase (ASP), used in the treatment of ALL since the 1960’es [23], which causes depletion of L-asparagine, “starving” lymphoblasts but also reducing hepatic protein synthesis [24]; pegylation of ASP prolongs this effect [25].