Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Hepatotoxicity During Maintenance Therapy and Prognosis in Children With Acute Lymphoblastic Leukemia

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Hearing Status in Survivors of Childhood Acute Myeloid Leukemia Treated With Chemotherapy Only: A NOPHO-AML Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Liposomal Cytarabine Induces Less Neurocognitive Dysfunction Than Intrathecal Methotrexate in an Animal Model

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Successful Treatment of Rhino-Orbital-Cerebral Mucormycosis in a Child With Leukemia

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Candidate single nucleotide polymorphisms and thromboembolism in acute lymphoblastic leukemia - A NOPHO ALL2008 study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Vi skal blive bedre til at teste for latent tuberkulose i Danmark

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. LISTERIA MENINGITIS IN DANISH CHILDREN 2000-2017: A Rare Event Even in a Country With High Rates of Invasive Listeriosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Response to: Patient-centred medical education: A proposed definition

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

Hepatotoxicity is a known toxicity to treatment of childhood acute lymphoblastic leukemia. Hepatotoxicity occurs during maintenance therapy and is caused by metabolites of 6-Mercaptopurine (6 MP) and Methotrexate (MTX). Our objective was to investigate the association between alanine aminotransferases (ALAT) levels and relapse rate. We included 385 patients enrolled in the NOPHO ALL-92 protocol. Data on ALAT levels, 6 MP and MTX doses, cytotoxic MTX/6 MP metabolites, and thiopurine methyltransferase (TPMT) activity were prospectively registered. In total, 91% of the patients had a mean ALAT (mALAT) level above upper normal limit (40 IU/L) and ALAT levels were positively correlated to 6 MP doses (rs=0.31; P<0.001). In total, 47 patients suffered a relapse, no difference in mALAT levels were found in these compared with nonrelapse patients (median, 107 vs. 98 IU/L; P=0.39). mALAT levels in patients classified as TPMT high activity (TPMT) were higher than in TPMT low-activity patients (median, 103 vs. 82 IU/L; P=0.03). In a Cox regression model risk of relapse was not associated with ALAT levels (P=0.56). ALAT levels increased 2.7%/month during the last year of maintenance therapy (P<0.001). In conclusion, elevated ALAT levels are associated with TPMT and may indicate treatment adherence in these patients. If liver function is normal, elevated ALAT levels should not indicate treatment adaptation.

OriginalsprogEngelsk
TidsskriftJournal of Pediatric Hematology / Oncology
Vol/bind39
Udgave nummer3
Sider (fra-til)161-166
Antal sider6
ISSN1077-4114
DOI
StatusUdgivet - apr. 2017

ID: 52772955