Locasciulli A, Vergani G M, Uderzo C, Jean G, Cattaneo M, Vergani D, Portmann B, Masera G
Cancer. 1983 Sep 15;52(6):1080-7. doi: 10.1002/1097-0142(19830915)52:6<1080::aid-cncr2820520625>3.0.co;2-k.
Liver disease during chemotherapy and after its completion was studied in 103 leukemic children in long-term remission. Seventy developed chronic liver disease during therapy; 22 out of 56 with adequate follow-up showed persisting abnormality or deterioration of liver function after stopping therapy. In 38 studied prospectively, biopsies were obtained at treatment withdrawal. Five showed chronic lobular, 17 chronic persistent, 9 chronic active hepatitis whereas 7 had minimal changes. These children had transiently detectable serum hepatitis-B virus (HBV) markers during (44.4%), at completion of (7.8%) and subsequent to (48.3%) chemotherapy. Serum HBV markers correlated significantly with both severity of histologic changes (P less than 0.05) and persistent biochemical abnormalities for over 6 months after treatment suspension (P less than 0.001). No direct relationship was found between drug administration and liver damage. The data from the study suggest that in leukemic children viral infections contribute to chronic liver damage, which can jeopardize the long-term prognosis of acute leukemia.
对103名处于长期缓解期的白血病患儿化疗期间及化疗结束后的肝脏疾病进行了研究。70名患儿在治疗期间出现慢性肝病；在56名接受充分随访的患儿中，22名在停止治疗后肝功能持续异常或恶化。在38名进行前瞻性研究的患儿中，在治疗结束时进行了肝脏活检。5名显示为慢性小叶性肝炎，17名显示为慢性持续性肝炎，9名显示为慢性活动性肝炎，而7名仅有轻微改变。这些患儿在化疗期间（44.4%）、化疗结束时（7.8%）及化疗结束后（48.3%）可短暂检测到血清乙肝病毒（HBV）标志物。血清HBV标志物与组织学改变的严重程度（P<0.05）以及治疗停止后6个月以上持续的生化异常均显著相关（P<0.001）。未发现药物使用与肝损伤之间存在直接关系。该研究数据表明，在白血病患儿中，病毒感染会导致慢性肝损伤，这可能危及急性白血病的长期预后。
