Parker D, Bate C M, Craft A W, Graham-Pole J, Malpas J S, Stansfeld A G
Cancer Chemother Pharmacol. 1980;4(2):121-7. doi: 10.1007/BF00254033.
Eight of 36 children receiving maintenance chemotherapy for acute lymphoblastic leukaemia or non-Hodgkin's lymphoma had liver biopsies on the basis of clinical abnormalities and/or elevated serum enzyme levels. Six biopsies were abnormal, including one in a boy with spider naevi who showed micronudular cirrhosis; he appeared to retain methotrexate in the blood for a prolonged period and his SGOT level did not return to normal for 19 months after maintenance chemotherapy was discontinued. The five other abnormal biopsies showed minor changes in the portal tracts. The six children with abnormal liver histology showed a wide variation in their early handling of an oral methotrexate dose. There was a statistically significant rise in mean SGOT and alkaline phosphatase during treatment, but the wide scatter in values precluded their use as accurate indicators of liver damage in these children.
36名接受急性淋巴细胞白血病或非霍奇金淋巴瘤维持化疗的儿童中，有8名因临床异常和/或血清酶水平升高接受了肝脏活检。6例活检结果异常，其中1例患有蜘蛛痣的男孩显示为小结节性肝硬化；他的血液中似乎长时间保留甲氨蝶呤，维持化疗停止后19个月，其谷草转氨酶水平仍未恢复正常。其他5例异常活检显示门静脉区有轻微变化。6例肝脏组织学异常的儿童在早期口服甲氨蝶呤剂量的处理上差异很大。治疗期间平均谷草转氨酶和碱性磷酸酶有统计学意义的升高，但数值的广泛离散使得它们不能作为这些儿童肝损伤的准确指标。
