DOI: https://doi.org/10.30841/2307-5112.1-2.2020.204518

The Role of Ursodeoxycholic Acid in Prevention of Liver Injury Caused by Chemotherapy of Acute Lymphoblastic Leukemia Associated with Obesity

Г. С. Маслова, І. М. Скрипник, О. В. Щербак

Abstract


Chemotherapy (ChT) in patients with acute lymphoblastic leukemias (ALL) is associated with higher risk of hepatotoxic reactions onset, especially in case of additional risk factors.

The objective: to assess the efficiency of ursodeoxycholic acid (UDCA) for hepatotoxic reactions prevention in patients with ALL and concomitant obesity who undergo ChT.

Materials and methods. 26 patients with newly diagnosed ALL and concomitant overweight and obesity were examined, 9 (34.6%) of them were females and 17 (65.4%) – males. Patients’ examination was conducted twice: before ChT and on the 28th day. Biochemical blood tests were made: alanine aminotransferase (ALT), aspartate aminotransferase, total protein, total bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), urea. The patients were divided onto two groups: І (n=12) – patients with ALL and obesity who were prescribed only ChT; II (n=14) – patients with ALL and obesity who were prescribed ChT and UDCA 15 mg/kg/day from the 1st to the 28th days.

Results. 83.3% (10/12) patients of the Іst group and 14.3% (2/14) patients of the ІІnd group had changes in liver function tests after ChT. The patients with ALL an concomitant obesity who underwent ChT were under the risk of hepatotoxic reactions (RR=5.00; 95% СІ=1.37-18.17; р<0.05), that were characterized by ALT elevation 2.05 times more, GGT – 2.4 times more, total bilirubin – 2.08 times and simultaneous decline of total protein 1.4 less (р<0.05). UDCA prescription to the patients with ALL and obesity, who undergo ChT is accompanied by decreased risk of cytostatic-induced liver injury (RR=0.17; 95% СІ=0.046-0.63; р<0.05).

Conclusions. In the settings of ChT, hepatotoxic reactions of mixed type are developed in patients with ALL and obesity, and UDCA prescription is an effective method for their prophylaxis.

Keywords


acute lymphoblastic leukemia; obesity; chemotherapy; hepatotoxic reactions; ursodeoxycholic acid

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ISSN (print): 2307-5112.