Evaluating the risk factors for liver injury in patients with chronic lymphocytic leukemia in the dynamics of chemotherapy
Journal Title: Гастроентерологія - Year 2019, Vol 53, Issue 2
Abstract
Background. B-cell chronic lymphocytic leukemia (B-CLL) treatment is accompanied by a risk of liver injury due to factors that depend on the characteristics of the patient, tumor, and chemotherapy (CT). The purpose was to assess the risk of development and nature of liver injury in patients with B-CLL in the dynamics of CT. Materials and methods. Seventy-six patients with В-CLL were examined, including 44 (57.9 %) men and 32 (42.1 %) women. The average age was (66.81 ± 12.50) years. The B-CLL stage was determined according to the Rai (1975, 1987) and Binet (1981, 2006) classifications. CT was administered in FC (fludarabine, cyclophosphamide) regimen. The patients were examined twice: before CT and after two FC courses. Hyperplastic syndrome and hyperleukocytosis were taken into account. Biochemical blood tests were evaluated. Common Terminology Criteria for Adverse Events, version 4.02, were used. Results. Advanced B-CLL stages (stage IV (C) according to Rai, Binet) are associated with an increased risk of no response on CT (risk ratio (RR) = 0.53; 95% confidence interval (CI) = 0.31–0.90; p < 0.05). The presence of hyperplastic syndrome is accompanied by a significant risk of no response on CT (RR = 0.23; 95% CI = 0.07–0.80; p < 0.05). Liver injury is more often detected in patients with B-CLL stages III (RR = 1.96; 95% CI = 1.33–2.88; p < 0.05) and IV (RR = 2.13; 95% CI = 1.47–3.08; p < 0.05) versus stage II by Rai. In patients with B-CLL, the risk of hepatotoxic reactions development is associated with low efficacy of CT, namely the achievement of partial response (RR = 3.18; 95% CI = 1.93–5.22; p < 0.05) and no response on CT (RR = 3.71; 95% СІ = 2.37–5.81; р < 0.05). Conclusions. The risk of liver injury increases in patients with B-CLL stage IV (C) and is associated with low CT efficacy.
Authors and Affiliations
G. S. Maslova, I. M. Skrypnyk
Keywords
Related Articles
- EP ID EP582154
- DOI 10.22141/2308-2097.53.2.2019.168986
- Views 80
- Downloads 0
ANGIODYSPLASIA OF THE SMALL INTESTINE — A RARE CAUSE OF OCCULT GASTROINTESTINAL BLEEDING
The review of literature shows the causes of occult gastrointestinal bleeding, and reports the role of angiodysplasias (arteriovenous malformations) in their development. There are presented results of own research — ide...
Doctors-Devotees in the Field of Zemstvo Medicine
Zemstvo medicine as a form of medical service to rural population appeared in the second half of the XIX century. Zemstvo was responsible for taking care of public health, medicine became a social service. The developmen...
Zemstvo Doctor and Dramatist
The study of the life and professional activity of Hryhorii Maksymovych Borakovskyi (1846–?), zemstvo doctor, doctor of medicine, forensic expert, public figure, writer, extraordinary personality, has been carried out. H...
Management of Patients with Gastroesophageal Reflux Disease in the Light of the Recent American Consensus
The paper gives a review of a new consensus on the diagnosis and management of patients with gastroesophageal reflux disease (GERD), developed by the American College of Gastroenterology, discusses how the approaches rec...
The Role of Sexual Dimorphism in the Development of Non-Alcoholic Fatty Liver Disease
Metabolic liver disease is often accompanies diseases of various body systems. Non-alcoholic fatty liver disease (NAFLD) — the most common pathology, associated with insulin resistance, diabetes mellitus and obesity. Th...