6-Mercaptopurine hepatotoxicity during acute lymphocytic leukemia maintenance therapy

Autor: Valerie Relias, J. Andrew Skirvin, Amy W. Valley, Ashley Morris
Rok vydání: 1998
Předmět:
Zdroj: Journal of Oncology Pharmacy Practice. 4:117-120
ISSN: 1477-092X
1078-1552
DOI: 10.1177/107815529800400203
Popis: Purpose. To describe a case of 6-mercaptopurine acute fulminate hepatotoxicity. Case Summary. A 65-year-old male with adult acute lymphocytic leukemia was receiving mainte nance therapy with 6-mercaptopurine and methotrex ate when he presented with jaundice, nausea, diar rhea, dysuria, right upper quadrant pain, and dark urine. He presented with elevated bilirubin, aspartate aminotransferase, and alanine aminotransferase. The work-up was negative for other causes of liver dam age. His hospital course included antibiotic therapy, vitamin K, and filgrastim. He was discharged without long-term morbidity from the event and had a normal ization of liver enzymes as an outpatient. Methotrex ate maintenance therapy was continued successfully as an outpatient for > 1 year. Conclusion. 6-Mercaptopurine is not commonly considered as an agent causing acute hepatotoxicity, but should not be ruled out as a causative agent in the setting of concurrent methotrexate therapy. An epi sode of acute hepatotoxicity did not preclude the continued, safe use of methotrexate in this case.
Databáze: OpenAIRE