HEPATOTOXICITY IN THE TREATMENT OF ACUTE LYMPHOBLASTIC-LEUKEMIA

被引：29

作者：

TOPLEY, JM ^{[1
]}

BENSON, J ^{[1
]}

SQUIER, MV ^{[1
]}

CHESSELLS, JM ^{[1
]}

机构：

[1] HOSP SICK CHILDREN,LONDON WC1N 3JH,ENGLAND

来源：

MEDICAL AND PEDIATRIC ONCOLOGY | 1979年 / 7卷 / 04期

关键词：

6‐mercaptopurine; acute lymphoblastic leukaemia; liver damage; methotrexate;

D O I：

10.1002/mpo.2950070415

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Serial liver function tests and percutaneous liver biopsies were performed on 21 children receiving treatment for acute lymphoblastic leukaemia (ALL). The patients received continuing chemotherapy either with daily 6‐mercaptopurine and weekly methotrexate or with five‐day pulses of these drugs every three weeks. Liver function tests were transiently abnormal in the majority of children, but the abnormalities bore no relationship to the histology of the liver biopsy. Mild inflammatory and fatty changes were commonly seen, and early portal fibrosis was found in three out of 16 patients biopsied at between 108–130 weeks on treatment. There was no correlation between treatment regime and results of biopsy. Three patients showed possible progression of abnormalities on repeat biopsy. The risk of development of portal fibrosis appears low after 2–3 years of continuing chemotherapy, but examination of liver histology may be indicated if more prolonged therapy is contemplated. Copyright © 1979 Wiley‐Liss, Inc., A Wiley Company

引用

页码：393 / 399

页数：7

共 10 条

[1] Nesbit M, Krivit W, Heyn R, Sharp H, Acute and chronic effects of methotrexate on hepatic, pulmonary and skeletal systems, Cancer, 37, pp. 1048-1054, (1976)
[2] McIntosh S, Davidson DL, O'Brien RT, Pearson HA, Methotrexate hepatoxicity in children with leukaemia, J Pediatr, 90, pp. 1019-1021, (1977)
[3] Rapson NT, Cornbleet MA, Chessells JM, Bennett AJ, Hardisty RM
[4] McIlvanie SK, McCarthy JD, Hepatitis in association with prolonged 6‐mercaptopurine therapy, Blood, 14, pp. 80-90, (1959)
[5] Einhorn M, Davidsohn I, Hepatotoxicity of mercaptopurine, JAMA, 188, pp. 802-806, (1964)
[6] Haskell CM, Cannellos GP, Leventhal BG, Carbone PP, Block JB, Serpick AA, Selawry OS, L‐asparaginase: Therapeutic and toxic effects in patients with neoplastic disease, N Engl J Med, 281, pp. 1028-1034, (1969)
[7] Roenigk HH, Bergfeld WF, Jacques R, Et al., Hepatotoxicity of methotrexate in the treatment of psoriasis, Arch Dermatol, 103, pp. 250-261, (1971)
[8] Dahl MGC, Gregory MM, Scheuer PJ, Liver damage due to methotrexate in patients with psoriasis, Br Med J, 1, pp. 625-630, (1971)
[9] Weinstein GD, Methotrexate, Ann Intern Med, 86, pp. 199-204, (1977)
[10] Dahl MGC, Gregory MM, Scheuer PJ, Methotrexate hepatotoxicity in prosiasis: comparison of different dose regimens, Br Med J, 1, pp. 654-656, (1972)

← 1 →