A Single-center Clinical Analysis of Drug-Induced Liver Injury in Children with Acute Leukemia
Bai Taomin
Children's Hospital of Shaanxi Provincial People's Hospital, Shaanxi Provincial Pediatric Diagnosis and Treatment Center, Xi'an-710068, China.
Liu Hong
Children's Hospital of Shaanxi Provincial People's Hospital, Shaanxi Provincial Pediatric Diagnosis and Treatment Center, Xi'an-710068, China.
Liu Na
Children's Hospital of Shaanxi Provincial People's Hospital, Shaanxi Provincial Pediatric Diagnosis and Treatment Center, Xi'an-710068, China.
Niu Qian
Children's Hospital of Shaanxi Provincial People's Hospital, Shaanxi Provincial Pediatric Diagnosis and Treatment Center, Xi'an-710068, China.
Jiao Fuyong *
Children's Hospital of Shaanxi Provincial People's Hospital, Shaanxi Provincial Pediatric Diagnosis and Treatment Center, Xi'an-710068, China.
*Author to whom correspondence should be addressed.
Abstract
Introduction: To analyze the clinical characteristics and influencing factors of drug-induced liver injury (DILI) in pediatric patients with newly diagnosed Acute Lymphoblastic Leukemia (ALL) during chemotherapy, using a retrospective analysis.
Methods: A retrospective analysis was conducted on 189 pediatric ALL patients treated at our institution from January 2019 to March 2024. The incidence and related factors of DILI were assessed, including body mass index (BMI), vitamin D levels, absolute neutrophil counts, and the number of blood transfusions.
Results: The study found that the incidence of DILI was 21.34%. Statistical analysis indicated that BMI, vitamin D levels, absolute neutrophil counts, and the number of transfusions were independent factors influencing the occurrence of DILI during chemotherapy in children with ALL (P<0.05). Moreover, DILI presented in various forms, predominantly as hepatocellular injury, mixed type, and cholestatic type, with hepatocellular injury being the most common.
Conclusion: Body mass index, vitamin D levels, absolute neutrophil counts, and the number of transfusions are critical independent factors affecting the development of drug-induced liver injury in pediatric patients with acute leukemia during chemotherapy. In clinical practice, proactive intervention on these factors is essential. Prompt actions such as discontinuing or adjusting medication dosages, hepatic protection, enzyme reduction, and jaundice management are vital to ensure the recovery of all patients.
Keywords: Children, acute lymphoblastic leukemia, chemotherapy, drug-induced liver injury