Hepatotoxicity following vincristine therapy

Abstract

A patient is reported with small cell lung cancer treated with combination chemotherapy (cyclophosphamide, vincristine and etoposide [VP‐16‐213] who developed transient liver function abnormalities secondary to vincristine therapy. Serum transaminase (SGOT and SGPT) levels rose by 2 to 6 times, lactic dehydrogenase (LDH) 1.5 to 2 times, and alkaline phosphatase and gamma‐glutamyl transpeptidase (GGTP) 1.5 to 2 times normal. Enzyme abnormalities were observed by the 6th day following drug administration and returned to normal between 16 and 48 days, except for the GGTP elevations which persisted longer. Vincristine has been suspected to cause liver damage and to enhance radiation‐induced hepatic injury. The authors report this case of moderate transient transaminitis confirmed by rechallenge with vincristine.

Hepatomegaly and fever at the time of neutrophil recovery revealing L-asparaginase toxicity in the treatment of acute lymphoblastic leukemia

“…Vincristine and cyclophosphamide have been rarely associated with liver abnormalities. Furthermore, microvesicular steatosis has never been reported with these agents [15,16]. Hepatomegaly, pathology showing severe macro- and microvesicular steatosis with mild necrosis, as previously described [7,8,11], and rapid improvement after L-aspa discontinuation were in favor of L-aspa specific toxicity.…”

Antinociceptive Activities of the Methanolic Extract of the Stem Bark of Boswellia dalzielii Hutch. (Burseraceae) in Rats Are NO/cGMP/ATP‐Sensitive‐K+ Channel Activation Dependent

“…These results indicate that, in addition to protecting against the development of neuropathic pain, BDME can also prevent side effects development (hematologic and hepatic) related to the administration of vincristine. Indeed, vincristine administration in patients results in bone marrow suppression and severe hepatic injury [ 56 , 57 ]. The biochemical restoration observed in this study may be due to the effect of BDME on the regulation of immune system and/or its hepatoprotective properties, which may be related to the antioxidant properties of BDME or to its inhibitory effect on cytochrome P 450 or to the inhibition of the synthesis of enzyme responsible for injury and inflammation of hepatocytes [ 58 ].…”

Histopathological Features of L-Asparaginase-Induced Liver Disease

“…[10][11][12] Acute hepatocellular injury has also been documented after high-dose methotrexate therapy. 13,14 Veno-occlusive disease of the liver is a common complication reported with VCR, adriamycin, and CTX regimen after allogenic and autogenic bone marrow transplantation for solid tumor and lymphoma 15,16 but has not been reported with standard chemotherapy for ALL. On the other hand, most chemotherapeutic agents (VCR, CTX, and Daun.)…”