LIVER DYSFUNCTION IN PATIENTS WITH ACUTE MYELOGENOUS LEUKEMIA - STUDIES ON PATIENTS NOT INFECTED WITH HEPATITIS-C VIRUS DURING INTENSE THERAPY

Liver dysfunction often occurs during chemotherapy for AML, but the et iologies are many and varied. To determine liver dysfunction that is n ot related to HCV, liver function during intense therapy for one week after complete remission was studied in eight patients not infected wi th HCV (38 courses) and six HCV-infected patients (19 courses) with AM L. There were remarkable differences in changes of ALT levels among HC V-infected patients. ALT level changes among patients not infected wit h HCV were similar. Changes in mean serum BLT levels in HCV-infected p atients occurred at higher serum levels as compared with those in pati ents not infected with HCV. The mean serum BLT levels in patients not infected with HCV significantly increased at one week (45 +/- 5 IU/I) and further increased at two (58 +/- 8 IU/I) and three weeks(57 +/- 5 IU/I) as compared with pretreatment levels (24 +/- 21 IU/I) (p < 0.001 , p < 0.001, p < 0.0001, respectively). ALT levels returned to normal at four weeks. During 31 of 38 courses (81.6%) in patients not infecte d with HCV, febrile episodes occurred at three weeks. The mean serum A LT levels in patients with febrile episodes were significantly higher than those in patients without febrile episodes at three weeks, and se rum ALT levels at three weeks showed a significant positive correlatio n with CRP levels at three weeks. These findings indicate that liver d ysfunction during chemotherapy for AML is due to hepatocellular injury , and infection or inflammatory cytokine induced by infection results in the worsening of the liver dysfunction.