Liver Function Tests in Patients of Acute Leukemia before and after Induction Chemotherapy

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 process itself. Objective: To evaluate the status of liver function in acute leukemia patients before and after induction chemotherapy. Methodology: This was a prospective cross-sectional study conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh from January 2017 to December 2017 on fifty (50) 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 0.89 ± 0.64 mg/dl. It was significantly (p < 0.001) raised to 1.55 ± 1.05 mg/dl at day 14 of chemotherapy, and again significantly (p < 0.002) reduced to 0.72 ± 0.35 mg/dl at day 30 of chemotherapy as compared to day 1. Similarly the mean serum ALT at day 1 was 47.46 ± 15.00 U/L which significantly (p < 0.001) raised to 87.08 ± 57.45 U/L at day 14 of chemotherapy and significantly (p < 0.001) reduced at day 30 of chemotherapy to 37.79 ± 11.69 U/L as compared to day 1. The mean serum aspartate transaminase (AST) before chemotherapy at day 1 was 38.00 ± 7.34 U/L that significantly (p < 0.001) increased to 44.96 ± 8.29 U/L at day 14 of chemotherapy and significantly (p < 0.001) decreased to 32.29 ± 4.78 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.