Liver dysfunction in children with hematologic malignancy or solid tumor
Keywords:
liver dysfunction, hematologic malignancy, solid tumor, children
Abstract
Background Deficiencies in liver synthetic function can only bedetected if the damage is severe, which are more often due to non
hepatic factors such as malignancies, both hematologic and solid
tumor.
Objective To assess liver function in children with either hemato-
logic malignancy or solid tumor and to find out which one of them
mostly affects liver function.
Methods A retrospective study was conducted on 125 children
with malignancies in the Sub division of Hemato-Oncology De-
partment of Child Health, Adam Malik Hospital, Medan, from Janu-
ary 1999 until May 2000. The inclusion criteria included all pa-
tients who were younger than 15 years and had not received any
treatment yet. The differences between prevalent liver dysfunction
in both groups were assessed by using chi-square test; Fisher’s
exact test was used to know the type of liver cell damage.
Results Liver dysfunction occurred in both types of malignancies. A
decrease of albumin level was not significant in both groups. There
was a statistically significant difference between the prolonged
prothrombine time (PT) in hematologic malignancy (26.4%) and that
in solid tumor (10.4%) with p=0.03. There was no significant differ-
ence in the elevation of serum transaminase concentration, total
bilirubin, and alkaline phosphatase. Based on aspartate aminotrans-
ferase (AST) and alanine aminotransferase (ALT) ratio, we found
that the type of liver cell damages was infiltrative disorders, occurred
13 out of 20 cases with elevated AST and ALT.
Conclusion Liver dysfunction occurred in both types of malig-
nancy; it occurred more frequently in hematologic malignancy than
in solid tumors
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2. Maller ES. Laboratory assessment of the liver function
and injury in children. In: Suchy FJ, editor. Liver dis-
ease in children. St.Louis: Mosby; 1994. p. 269-82.
3. Grendell JH. The liver in systemic disease. In: Fried-
man LS, Keefe EB, editors. Handbook of liver dis-
ease. Churcill Livingstone: Harcourt Brace Co; 1998.
p. 305-13.
4. Beath S. The liver in systemic illness. In: Suchy FJ,
editor. Liver disease in children. St.Louis: Mosby; 1994.
p. 213-27.
5. Farrell MK, Bucuvalas JC. Systemic disease and the
liver. In: Suchy FJ, editor. Liver disease in children.
St.Louis: Mosby; 1994. p. 580-97.
6. Poplack DG. Acute lymphoblastic leukemia. In: Pizzo
PA, Poplack DG, editors. Principles and practice of
pediatric oncology. 2 nd ed. Philadelphia: Lippincott;
1993. p. 431-65.
7. Manus MJ, Gilchrist. Neuroblastoma. In: Behrman
RE, Kliegman RM, Jenson HB, editors. Textbook of
pediatrics. 16 th ed. Philadelphia: Saunders; 2000. p.
1552-4
8. Altman AJ, Quinn J. Management of malignant solid
tumors. In: Nathan DG, Orkin SH, editors. Hematol-
ogy of infancy and childhood. 5 th ed. Philadelphia:
Saunders; 1998. p. 1389-99.
9. Farrell. Drug–induce liver disease. London: Churchill
Livingston; 1994. p. 473-87.
10. Menard DB, Gisselbrech, Marty M, Reyes F,
Dhumeaux. Antineoplastic agents and the liver. In:
Gastroenterology 1980;78:142-64.
11. Poley JR. Laboratory investigation of hepatic function
and dysfunction. In: Gracey M, Burke V, editors. Pedi-
atric gastroenterology and hepatology. 4 th ed. Boston:
Blacwell Scientific publication; 1993. p. 768-76.
12. Zimmerman HJ. Test of hepatic function and diag-
nosis studies. In: Clinical diagnosis by laboratory
methods. 5 th ed. Philadelphia: Saunders; 1974. p.
804-35.
13. Martin P, Friedman LS. Assessment of liver function
and diagnostic studies. In: Friedman LS, Keefe EB,
editors. Handbook of liver disease. Churchill
Livingston: Harcourt Brace Co; 1998. p. 1-14.
14. WHO. Measuring change in nutritional status. Guide-
lines for assessing the nutritional impact of supple-
mentary feeding programs for vulnerable groups.
Geneva: WHO; 1983. p. 63-101.
15. Departemen Kesehatan RI. Hasil dan rekomendasi
semiloka antropometri di Indonesia.;1991 Feb 3-7;
Ciloto. Jakarta: Depkes RI; 1991. p.1-5.
16. Nicholson JF, Pesce MA. References ranges for labo-
ratory test and procedures. In: Behrman RE,
Kliegman RM, Jenson HB, editors. Textbook of pe-
diatric. 16 th ed. Philadelphia: Saunders; 1998. p.
2187-91.
17. Gilchrist. Lymphoma. In: Berhman RE, Kliegman
RM, Jenson HB, editors. Nelson textbook of pediat-
ric. 16 th ed. Philadelphia: WB Saunders Co; 2000. p.
1548-52.
18. Christ WM, Smithson WA. The leukemias. In:
Behrman RE, Kliegman RM, Jenson HB, editors. Text-
book of pediatrics. 16 th ed. Philadelphia: Saunders;
2000. p. 1543-6.
19. Niemeyer CM, Sallan SE. Acut lymphoblastic leuke-
mia. In: Nathan DG, Orkin SH, editors. Hematology
of infancy and childhood. 5 th ed. Philadelphia:
Saunders; 1998. p.1245-68
20. Lavelle JM. Weight loss. In: Fleisher GR, Ludwig S,
Henretig FM, editors. Texbook of pediatric emergency
medicine. 4 th ed. Philadelphia: Lippincott Williams
& Wilkins; 2000. p. 651-5.
21. Christ WM. Principles of diagnosis. In: Behrman RE,
Kliegman RM, Jenson HB, editors. Textbook of pedi-
atric. 16 th ed. Philadelphia: WB Saunders Co; 1998.
p. 1536-7.
22. Kibirige MS, Jones PHM, Stevens RF. Indicator mal-
nutrition in leukemic children. Arch Dis Child
1987;845-6.
23. Rickard AK, Coates TD, Grosfeld JL, Weetman RM,
Baehner RL. The value of nutritional support in children
with malignancy. Malignancy 1986;1904-10. Citation from:
Kibirige MS, Jones PHM, Stevens RF. Indicator malnutri-
tion in leukemic children. Arch Dis Child 1987;845-6.
24. Alexander HR, Rickard KA, Godshall B. Nutritional
supportive care. In: Pizzo PA, Poplack DG, editors.
Principles and practice of pediatric oncology. 3 rd ed.
Philadelphia: Lippincott; 1997. p. 1167-.79
25. Haskel CM, Cenellos GP, Leventhal BG, Carbone PP,
Block JB, Serpic AA, et al. L-asparaginase therapeutic
and toxic effect in patient with neoplastic disease. N
Engl J Med 1969;6:1028-34.
26. Dahl MGC, Gregory MM, Scheuer PJ. Methotrexate
hepatotoxicity in psoriasis. Comparison of different
dose regiments [retracted from Gastroenterology
1980;78:142-64] Br J Med 1972;654-6.
27. Goodell B, Leventhal B, Henderson E. Cytosin arabi-
noside in acute granulocytic leukemia. [retracted from
Gastroenterology 1980;78:164].Clin Pharmacol Ther
1971;12:599-606.
Published
2016-09-24
How to Cite
1.
Carmelia R, Lubis B, Sutjipto A, Hariweni T. Liver dysfunction in children with hematologic malignancy or solid tumor. PI [Internet]. 24Sep.2016 [cited 24Apr.2024];43(4):126-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/675
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Received 2016-09-23
Accepted 2016-09-23
Published 2016-09-24
Accepted 2016-09-23
Published 2016-09-24
