Risk factors affecting the development of hepatic complications during treatment of leukemia

ABSTRACT Introduction and Purpose: During the the treatment of leukemia application of chemotherapy in hepatic acute, is an important complication that affects the patient's performance status and life expectancy. The aim of this study to determine the frequency of acute hepatitis of patients treated in our clinic with the diagnosis of leukemia during treatment and to identify risk factors for the development of which may be effective. Materials and Methods: The study viewed patients treated for leukemia in Dicle University's Hospital Hematology clinic between 2008-2013. the data were collected retrospectively from patients admission on the clinic until the end of chemotherapy protocol. Demographic characteristics of patients, the main diagnosis, liver function tests before and during treatment, hepatitis markers, applied treatment schemes, amount of supplied blood products, the results of taken cultures and encountered complications during the treatment were recorded. Patient group who, ALT and / or AST levels increased two-fold or greater compared to pre chemotherapy During and / or after the chemotherapy, was considered as acute hepatitis. Findings: 125 subjects with mean age of 45.2 (62 men) suffering from leukemia is studied. 63 of patients(50,4%)are diagnosed with acute myeloblastic leukemia, 17 (%13.6) akut of them are diagnosed with acute lymphoblastic leukemia, 21 of them (%16.8) are diagnosed with chronic myeloid leukemia and 24 of them (%19.2) are diagnosed with chronic lymphocytic leukemia. acute hepatitis was developed in Seventy-three (58.4%) patients due to treatment. Although acute hepatitis developed in 56 of the 80 patients of acute leukemia (70%) patients, acute hepatitis developed in 17 of 45 patients with chronic leukemia (37.7%) patients. Compared with Chronic leukemia, acute hepatitis is significantly more common in the patient of acute leukemia(p=0.001). Acute hepatitis developed in all of patients of eight cases which have positive HBsAg before treatment . There was no relationship between gender and the development of acute hepatitis while The mean age of the patients of acute hepatitis is significantly smaller than, those who were acute hepatitis (42,11±17,9 vs. 49,9±19 year; p=0.021). The amount of packed red blood cells and platelets of patients who acute hepatitis developed in, significantly more than those acute hepatitis not developed in. (9,3±7,7 vs 5,6±7,4 unit; p=0.008, 8,2±8,6 vs 4,8±7,6 unit; p=0.027 respectively). Mortality during follow-up of patients with and without acute hepatitis patients was not significantly different (% 30,1 vs.%17,3; p=0.141). There was significantly more increasing in blood samples of patients who acute hepatitis developed in, compated with patients who acute hepatitis not developed in (%46,2 vs 24,2; p=0.048). Result: During treatment of leukemia patients, although there is relationship between the development of acute hepatitis with low age, the presence of acute leukemia, HBsAg pozitivity, the amount of blood growth and proliferation at blood culture, it can be seen that the development of acute hepatitis has no significant effect on mortality. Keywords: Acute hepatitis, Leukemia.