Phenazone as a marker of liver-metabolic function in patients with acute leukemia

Objective: The aim of this work.. was to study the influence of neoplastic disease, especially acute myeloblastic leukemia (AML), and its chemotherapy on the activity of hepatic microsomal enzymes by using phenazone, as a mar ker of oxidative drug metabolizing activity. Methods: The observations were carried out in 21 patients with AML and in 53 healthy volunteers. The infl uence of disease on phenazone kinetics was studied before chemotherapy and the effect of anticancer drugs administration after the first cycle of chem otherapy. Results: The mean phenazone half-life time was significantly shor ter in patients with AML (8.79 (3.01) h) than in control group (11.08 (3.61 ) h) (p < 0.012). Treatment with anticancer drugs, especially with epirubic ine, inhibited phenazone elimination. The mean phenazone half-life time was significantly longer (18.08 (8.80) h) and the mean metabolic clearance rat e was significantly smaller (33.92 (15.40) ml/min) after chemotherapy in co mparison with the initial value, before treatment (10.22 (2.90) h), (p < 0. 01) (50.33 (20.29) ml/min) (p < 0.008). Conclusion: Our results lead to the conclusion that phenazone is an important index of hepatic metabolic capac ity in patients with acute myeloblastic leukemia. The evaluation of its kin etics allowed to early recognition of the presence and the degree of drug o xidizing modification. Acceleration of phenazone elimination before treatme nt and its inhibition after chemotherapy, particulary epirubicine, may sugg est that in patients with AML elimination of the other drugs metabolized by the pathway similar to phenazone also may be changed. It should be conside red in individualization of their dosage regimen.