title: Pattern of Liver Disease Following High-Dose Cytosine Arabinoside (HDARAC) Therapy in Children with Acute Myeloid Leukemia.
abstract: The occurrence of liver disease and its relation to HBV markers were investigated in ten children with AML who were given HDARAC as late consolidation therapy. None of them developed jaundice or biochemical evidence of cholestasis. During therapy, SGPT values were normal in 5/10 patients, while in the other 5 a sharp increase was noted. These enzyme elevations followed an unusual timing, peaking just before each infusion of HDARAC. Evidence of long-lasting hepatocellular necrosis after therapy withdrawal was found in 8/8 cases. One child died of fulminant type B hepatitis and HBsAg positivity was found in 2/10 patients during therapy and 3/8 after withdrawal of the drug. Three children developed HBV antibodies during the observation period. We conclude that the use of HDARAC in childhood leukemia is not associated with major evidence of direct drug hepatotoxicity while it clearly affects the natural outcome of viral hepatitis.
authors.affiliation: a Clinica Pediatrica Universita's di Milano, Ospedale "S. Gerardo", Monza, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Locasciulli
authors.affiliation: a Clinica Pediatrica Universita's di Milano, Ospedale "S. Gerardo", Monza, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Uderzo
authors.affiliation: a Clinica Pediatrica Universita's di Milano, Ospedale "S. Gerardo", Monza, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pirola
authors.affiliation: a Clinica Pediatrica Universita's di Milano, Ospedale "S. Gerardo", Monza, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Masera
authors.affiliation: b Liver Unit, King's College Hospital and Medical School, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Portmann
authors.affiliation: c Istituto di Medicina Clinica, Clinica Medica II Universita's di, Padova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Alberti
keywords: Ara-C; HBV infection; acute myeloid leukemia