pirarubicin and Hepatitis

A 25 year-old woman diagnosed as acute myelocytic leukemia (M0) suffered a fourth relapse in February 1992 at which time she already had anthracycline-induced cardiac dysfunction. Although remission was induced by low dose cytosine arabinoside and etoposide combined with pirarubicin, she developed acute heart failure followed by extreme elevation of transaminases level and DIC. Abdominal echography and CT revealed small round lesions in the liver. We diagnosed this episode as ischemic hepatitis because of the following clinical findings; serological markers of virus hepatitis were negative, hypotension and reduced blood flow to the liver were seen, and both transaminases and LDH were markedly elevated. Dobutamin and oxygen inhalation were started, her liver function returned to almost normal levels 8 days later.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Cardiomyopathies; Cytarabine; Doxorubicin; Etoposide; Female; Hepatitis; Humans; Ischemia; Leukemia, Myeloid, Acute; Liver; Remission Induction