THE ACUTE HEPATOTOXICITY OF INTERMEDIATE- DOSE MTX IN CHILDREN WITH ACUTE-LEUKEMIA AND NON-HODGKIN-LYMPHOMA

In the period of 1.1.1988 to 1.5.1992 49 children, 28 boys and 21 girl s, were treated with 219 MTX infusions. The acute hepatotoxicity was i nvestigated from day - 1 to day 5 of treatment duration. 30 patients s uffered of a ALL, 6 of a relapse of a ALL, 3 of a ANLL and 10 of a NHL . We studied the MTX dosage and the infusion time. At all patients the determination of the activity of the liver-enzymes ASAT, ALAT and GGT P in the serum took place according to the treatment protocol. The inc rease of enzymes activity correlated with the intensity and kind of he patocellular damage. Partly the extreme increase of lesion parameters is not the expression of an irreversible cytonecrosis. Beside the ALAT also the GGPT is a sensitive predictor of hepatocellular lesion. The high enzyme activity before the MTX application is a indicator of a pr eexistent cell damage of the liver. The hepatotoxicity measured in the serum was highly correlated with the AUC.