Low-dose cytarabine-induced hepatic and renal dysfunction in a patient with myelodysplastic syndrome

Acute Hepatotoxicity After High-Dose Cytarabine for the Treatment of Relapsed Acute Myeloid Leukemia: A Case Report

“…10 Tanaka et al discussed a patient who received low-dose cytarabine who developed hepatic dysfunction during the course of chemotherapy by an elevated AST/ALT (10x and 7x ULN, respectively), slight elevation of T.bili and acute renal failure. 11 Our patient had an abnormally high AST/ALT, a mild increase of serum creatinine, and although our patient exhibited mildly elevated bilirubin, it was during and before the discontinuation of HiDAC. A fourth reported case reported by Nachbaur et al was a young female patient who went into fulminant hepatic failure 25 days after the second course of HiDAC and mitoxantrone (HAM) treatment for a second relapse of AML.…”

“…The half-life of cytarabine is relatively short, within 1 to 3 hours in the elimination phase. 11 Without other obvious concurrent hepatotoxic medications or causes of the acute hepatic injury and lactic acidosis, we assigned this drug reaction a score of 5 on the Naranjo scale; it was probable that cytarabine, specifically, HiDAC, was associated with the observed hepatotoxicity. Clinicians should exercise caution when using cytarabine in elderly patients with and without preexisting hepatic conditions.…”

The management of prolonged, isolated hyperbilirubinemia following cytarabine-based chemotherapy for Acute Myeloid Leukaemia

“…1,2 Hepatic dysfunction, characterized by jaundice, elevations in serum bilirubin, transaminase, and alkaline phosphatase (ALP) has been reported in patients receiving cytarabine alone and in combination with other agents. [2][3][4] In this report, a case of prolonged, isolated hyperbilirubinemia after cytarabine-based chemotherapy is described.…”