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Title   항암 요법 중인 암환아의 간기능 이상에 영향을 미치는 인자 ( Adverse Factors of Hepatic Dysfunction during chemotherapy for childhood Malignancy )
Publicationinfo   1993 Jan; 025(03): 416-423.
Key_word   Childhood malignancy, Hepatic dysfunction, Chemotherapy, HCV
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Abstract   Hepatic dysfuction is one of the most commonly encountered problems in the treatment of children with malignancies. In order to determine the adverse factors on hepatic injury, one hundred and forty-seven patients with various childhood malignancies were studied. The patients were divided into two groups: Group 1, eighty-six with elevated serum alanine aminotransferase(s-ALT); Group 2, sixty-one with normal s-ALT. They were compared with regard to the laboratory characteristics, transfusion history, post-transfusion hepatitis B (HbsAg) and C(anti-HCV) markers, as well as the chemotherapeutic agents used. Patients in Group I received more transfusion than those in Group 2 because of low platelet and hemoglobin counts at diagnosis(P<0.01), but as much as 41% of transfused patients in Group I showed no causal time-relationship between transfusion and elevation of s-ALT, and also, only one case was positive for anti-HCV. Though eight patients in Group 1 were positive for HBsAg, only 3 patients became positive for HBsAg after transfusion. Considering the situation in Group 1, we suggest that elevated s-ALT caused by transfusion-associated viral infections may not be the chief factor causing hepatotoxicity. In group 1, chemotherapeutics like methotrexate, 6-mercaptopurine, L-asparaginase, cytarabine, vincristine, daunomycin, and cyclophosphamide were found to be associated with S-ALT elevation in more than half patients administerd. Accordingly, we concluded that anticancer agents played the most important role in causing the elevation of s-ALT in children with malignancy rather than transfusion-associated factors. Further evaluation not only for the transfusion-related viral hepatitis, such as Hepatitis C virus with better screening methods, cytomegalovirus, and Epstein-Barr virus, but also far other possible factors, not studied here is still required in larger, prosctive study.
저 자   고동훈(Dong Hoon Ko),임형종(Hyung Jong Im),최영권(Young Gweon Choi),국훈(Hoon Kook),황태주(Tai Ju Hwang)