Vol. 6, Issue 2, Part A (2024)

Background: Patients of acute leukemia require careful assessment of liver function prior to start chemotherapy to determine which drugs may be appropriate or to be modified. Post chemotherapy abnormalities of liver function tests may be due to drugs or due to disease itself.

Objective: To evaluate the status of liver function in Pediatric acute leukemia patients before and after induction chemotherapy.

Methodology: This was a prospective cross-sectional study conducted in the Department of Pediatric Hematology & Oncology Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh from January 2022 to December 2023 on sixty (60) newly diagnosed patients of acute leukemia who fulfilled the selection criteria. Blood samples for serum total bilirubin, alanine transaminase (ALT) and aspartate transaminase (AST) were collected before chemotherapy (Day 1) and after induction chemotherapy on 14th day and 30th day. Serum ALT and AST were measured by kinetic method and serum total bilirubin was measured by DMSO method. Data were analyzed and compared by statistical tests.

Result: In this study, the mean level of serum total bilirubin before chemotherapy at day 1 was 0.78± 0.72 mg/dl. It was significantly (p< 0.001) raised to 1.32±0.95 mg/dl at day 14 of chemotherapy, and again significantly (p<0.002) reduced to 0.71±0.45 mg/dl at day 30 of chemotherapy as compared to day 1. Similarly the mean serum ALT at day 1 was 43.55±12.23 U/L which significantly (p<0.001) raised to 89.04±58.22 U/L at day 14 of chemotherapy and significantly (p<0.001) reduced at day 30 of chemotherapy to 35.44±9.23 U/L as compared to day 1. The mean serum aspartate transaminase (AST) before chemotherapy at day 1 was 37.12±6.22 U/L that significantly (p<0.001) increased to 45.43±6.21 U/L at day 14 of chemotherapy and significantly (p<0.001) decreased to 34.21±4.33 U/L at day 30 of chemotherapy compared to baseline value at day 1.

Conclusion: It is concluded that serum total bilirubin, ALT and AST increase in response to chemotherapeutic drugs during treatment of acute leukemia.