The evaluation of frequency and character of hepatotoxic reactions in patients with acute myeloid leukemia in the dynamics of remission induction
Journal Title: Сучасна гастроентерологія - Year 2018, Vol 0, Issue 2
Abstract
Objective — to study the frequency and character of liver functional disturbances in patients with acute myeloid leukemia (AML) depending on the morphologic variant according to the FAB-classification and prescribed chemotherapeutic (ChT) scheme. Materials and methods. The investigation involved 63 patients with newly diagnosed AML, from them 29 (46 %) were women and 34 (54 %) men. The general ECOG performance status was I- II, the Karnofsky index was 60 to 80 %. The patients were divided into groups: the І group (n = 27) included patients with AML М0, М1, М2 according to FABcriteria; the ІІ group (n = 36) consisted of patients with AML М4, М5 according to FAB-criteria. The patients received the 1st remission induction course. Serum alanine and asparagine aminotransferases, alkaline phosphatase activity, total bilirubin concentration were assessed before the ChT start, and on the 7-th, 14-th, 28-th days of treatment. Results. The conduction of the 1-st remission induction course in AML patients with М0—М2 variants was accompanied by the І grade hepatotoxicity on the 7-th and 14-th days in 2 (7.4 %) patients, and in AML patients with М4—М5 variants — in 11 (30.5 %) patients, in 8 (22.2 %) out of them the grade І of severity was detected, in 3 (8.3 %) — grade ІІ. Hepatotoxic reactions in 2 (7.4 %) patients with AML М0, М1 and М2 variants of the group І were characterized as cytolytic. Among the patients of the group II with AML М4 and М5 variants the following types of hepatotoxic reactions were registered: cytolyticin 2 patients (5.5 %), cholestaticin 4 subjects (11.1 %) and mixed typein 5 (13.9 %) patients. In patients of all comparison groups, in whom liver tests disturbances were observed on the 7-th and 14-th days, the indicators of liver functional state were restored by the 28-th day. Conclusions. It has been established that М4—М5 AMLvariants were associated with an increased risk of the onsetof hepatotoxic reactions, that is determined by hemoblastosis morphology and higher toxicity of ChT regimens with inclusionof etoposide.
Authors and Affiliations
I. M. Skrypnyk, G. S. Maslova
Keywords
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