Assessment of hepatotoxicity of the induction therapy stage of acute lymphoblastic leukemia in children

Abstract

The article presents the analysis results of the functional state of liver at the stage of induction therapy of acute lymphoblastic leukemia in children under the ALL-MB-2015 program. The total number of examined patients from 1 to 18 years old is 33. The levels of hepatic transaminases (alanine aminotransferase - AlAT and aspartate aminotransfinase - AsAT) on the background of polychemotherapy exceeded normal rates in 97% of patients (n = 32). The maximum increase in AlAT and AsAT levels was noted by the 36th day of induction therapy: the median of AlAT was 414,5 U / l (312,5...914,0), the median of AsAT was 111,2 U / l (69,2...212,4), which significantly exceeded these levels during the initial diagnosis (AlAT - 22,2 U/l) and on the 15th day of induction (AlAT - 56,5 U/l). Toxic hepatitis of high degree of activity by the end of induction therapy was registered in all patients (n = 16) of the intermediate risk group with the additional administration of daunorubicin on the 22th day of induction. Considering the findings, in order to prevent hepatotoxicity, it was recommended to administer hepatoprotectors from the 10th day of induction polychemotherapy of acute lymphoblastic leukemia in children.