Hepatotoxicity Incidence And Risk Factors Among Adults and Pediatrics Acute Lymphoid Leukemia Patients On Chemotherapy Induction at Black Lion Specialized Hospital, Addis Ababa, Ethiopia, 2019
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Date
2020-01
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Addis Abeba University
Abstract
Chemotherapy-induced hepatotoxicity is a common cause of abnormal liver function test in patients
with ALL. L-asparginas is a drug for ALL patients as induction therapy. The majority of adverse
effects are hypersensitivity reactions, but serious liver and other organ related injury may occur.
Incidence rate and associated risk factors is not well document in our setting.
Objective: To assess hepatotoxicity incidence and risk factors among adults and pediatrics ALL
patients on chemotherapy induction at Black Lion Specialized Hospital, Addis Ababa, Ethiopia from
January 2019 – September, 2019.
Methodology: Hospital based prospective cohort study design was conducted from February 1,
2019– September 30, 2019 at BLSH hematology unit. A total of 40 admitted and consenting
participants were included in the study using convenient sampling technique. A relevant clinical and
demographic data and biochemical profile of liver function & pancreatic organ function tests were
computed using appropriate statistical tools. Descriptive statistics was used for most variables,
repeated measurement of ANOVA, paired T test and binary logistic regression was used to test the
association among various variables. P-value of < 0.05 was used as a measure of statistical
significance.
Result : From the total (40) ALL cases, an overall increased level of serum AST, ALT, ALP, total
bilirubin, direct bilirubin, amylase, lipase was found in 16(40%), 18 (45%), 19(47.5%), 19(47.5%),
27(67.5%) ,10(25%), and 9(22.5%) cases after induction therapy, respectively. The overall
hepatotoxicity among all the subjects was5% (2/40). The mean value of serum alkaline phosphatase,
total bilirubin, and bilirubin direct were significantly increased in ALL patients after induction
therapy as compared with before induction therapy. After induction therapy blirubin total was
significantly associated with alcohol intake and ALP was significantly associated with weight loose.
AST, ALT, blirubin direct, amylase and lipase were not associated with weight loose, alcohol intake,
age, gender and blood transfusion.
Conclusion: The finding of this study concluded that chemotherapy drugs like L-asparginase,
vincristine, Predensolon, Doxourobin and others cause significant alterations of clinical chemistry
tests like liver and pancreatic enzymes. These alterations could be contributed to liver and pancreatic
dysfunction on ALL patients. Patients more susceptible to hepatotoxicity such as those with
malnutrition or alcoholism should be followed up more closely. And also, pediatrics has acute
pancreatitis so they should have followed them more frequently.
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Keywords
Liver function Test, pancreatic test, acute lymphoid leukemia