Real World Experience of Drug Induced Liver Injury in Patients Undergoing Chemotherapy.
Real World Experience of Drug Induced Liver Injury in Patients Undergoing Chemotherapy.
复制标题
DOI：
10.21767/2575-7733.1000047
复制
发表时间：
2018-01-01
期刊：
影响因子：
--
通讯作者：
Odin, Joseph A
中科院分区：
文献类型：
--
作者：
Azad, Adiba;Chang, Paul;Odin, Joseph A
背景与目的：为了更好地了解化疗期间药物性肝损伤（DILI）的临床意义，我们研究了为期两年的泌尿生殖系统恶性肿瘤化疗患者中 DILI 的流行病学、发生率和治疗效果。 方法：我们对 284 名接受化疗的前列腺癌、膀胱癌、睾丸癌和肾细胞癌患者进行了回顾性分析。 年期间。化疗开始前肝功能检查（LT）结果异常或缺失的患者被排除在外。如果 ALT>3* ULN 和/或总胆红素 (TB)>2* ULN，且没有其他更可能导致 LT 升高的原因，则化疗后 LT 结果被定义为 DILI。 结果：整个研究人群中 DILI 的累积发生率为 6.1% (17/284)，在进行适当 LT 的人群中，该发生率增加至 18.9% (17/90)。 82% (14/17) 的患者确定化疗药物是 DILI 的原因，59% (10/17) 的患者改变了治疗计划。 结论：在这项现实世界研究中，DILI 的累积发生率高于临床试验中通常报道的水平，大多数受影响的患者不得不改变或中断其癌症治疗。
BACKGROUND & AIM: To better understand the clinical significance of drug induced liver injury (DILI) during chemotherapy, we examined the epidemiology, incidence, and treatment effects of DILI in patients undergoing chemotherapy for genitourinary malignancies over a two-year period.METHODS: We conducted a retrospective review of 284 patients who underwent chemotherapy for prostate, bladder, testicular and renal cell carcinomas over a two year period. Those with abnormal or absent liver test (LT) results prior to chemotherapy initiation were excluded. Post chemotherapy LT results were defined as DILI if ALT>3* ULN and/or total bilirubin (TB)>2* ULN, in the absence of other more likely causes of elevated LT.RESULTS: The cumulative incidence of DILI in the total study population was 6.1% (17/284), and in the population who had appropriate LT performed it increased to 18.9% (17/90). Chemotherapeutic agents were determined to be the cause of DILI in 82% (14/17) of patients, and the treatment plans were changed in 59% (10/17) of patients.CONCLUSION: In this real world study, the cumulative incidence of DILI was higher than commonly reported in clinical trials, and the majority of affected patients had to have their cancer treatment altered or interrupted.