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Clinico‐pathologic correlation of liver damage in patients treated with 6‐mercaptopurine and adriamycin
Author(s) -
Minow Robert A.,
Stern Michael H.,
Casey John H.,
Rodriguez Victorio,
Luna Mario A.
Publication year - 1976
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197610)38:4<1524::aid-cncr2820380413>3.0.co;2-w
Subject(s) - mercaptopurine , medicine , transaminase , cholestasis , alkaline phosphatase , gastroenterology , bilirubin , infiltration (hvac) , necrosis , leukemia , cirrhosis , refractory (planetary science) , pathology , enzyme , biology , biochemistry , physics , astrobiology , thermodynamics
Eleven adults with refractory leukemia treated with a combination of 6‐mercaptopurine and Adriamycin developed hepatic dysfunction manifested by elevations of serum total bilirubin, alkaline phosphatase, and glutamic oxaloacetic transaminase. Liver tissue obtained at necropsy showed intrahepatic cholestasis (eight cases), hepatocellular necrosis (ten cases), leukemic infiltration (two cases), and fatty change (nine cases). Neither this frequency nor severity of hepatocellular destruction has hitherto been associated with 6‐mercaptopurine at the dose levels used in this study, nor has Adriamycin previously been found to be hepatotoxic. It is postulated that Adriamycin potentiated the hepatotoxicity of 6‐mercaptopurine in these patients.