Acute myeloid leukemia presenting with hepatic dysfunction: Should induction be dose reduced?
Abstract The combination of de novo hepatic dysfunction and AML in a medically fit patient presents an unusual predicament. Cases present with obstructive jaundice and imaging typically shows diffuse hepatosplenomegaly, with some cases visualizing myeloid sarcomas causing biliary ductal dilatation....
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| Format: | Article |
| Language: | English |
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Wiley
2024-10-01
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| Series: | eJHaem |
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| Online Access: | https://doi.org/10.1002/jha2.979 |
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| author | Satish Maharaj Simone Chang |
| author_facet | Satish Maharaj Simone Chang |
| author_sort | Satish Maharaj |
| collection | DOAJ |
| description | Abstract The combination of de novo hepatic dysfunction and AML in a medically fit patient presents an unusual predicament. Cases present with obstructive jaundice and imaging typically shows diffuse hepatosplenomegaly, with some cases visualizing myeloid sarcomas causing biliary ductal dilatation. Guidelines for use of anthracyclines in hepatic dysfunction recommend dose reduction based on bilirubin blood levels, either to 50% or even omitting anthracycline. Randomized data however has shown that reduction of anthracycline in AML induction decreases overall survival and lowers remission rate. This case suggests, along withthe literature reviewed, that some medically fit patients with hepatic dysfunction benefit from and tolerate intensive induction therapy well without toxicity. |
| format | Article |
| id | doaj-art-d4fc205b98a642f882c3e08d2156f24d |
| institution | OA Journals |
| issn | 2688-6146 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | eJHaem |
| spelling | doaj-art-d4fc205b98a642f882c3e08d2156f24d2025-08-20T01:47:42ZengWileyeJHaem2688-61462024-10-01551092109510.1002/jha2.979Acute myeloid leukemia presenting with hepatic dysfunction: Should induction be dose reduced?Satish Maharaj0Simone Chang1Hematology/Oncology, Department of Oncologic Sciences University of South Florida Tampa Florida USAHematology/Oncology, Department of Oncologic Sciences University of South Florida Tampa Florida USAAbstract The combination of de novo hepatic dysfunction and AML in a medically fit patient presents an unusual predicament. Cases present with obstructive jaundice and imaging typically shows diffuse hepatosplenomegaly, with some cases visualizing myeloid sarcomas causing biliary ductal dilatation. Guidelines for use of anthracyclines in hepatic dysfunction recommend dose reduction based on bilirubin blood levels, either to 50% or even omitting anthracycline. Randomized data however has shown that reduction of anthracycline in AML induction decreases overall survival and lowers remission rate. This case suggests, along withthe literature reviewed, that some medically fit patients with hepatic dysfunction benefit from and tolerate intensive induction therapy well without toxicity.https://doi.org/10.1002/jha2.979anthracyclinehepaticleukemiamyeloidpharmacology |
| spellingShingle | Satish Maharaj Simone Chang Acute myeloid leukemia presenting with hepatic dysfunction: Should induction be dose reduced? eJHaem anthracycline hepatic leukemia myeloid pharmacology |
| title | Acute myeloid leukemia presenting with hepatic dysfunction: Should induction be dose reduced? |
| title_full | Acute myeloid leukemia presenting with hepatic dysfunction: Should induction be dose reduced? |
| title_fullStr | Acute myeloid leukemia presenting with hepatic dysfunction: Should induction be dose reduced? |
| title_full_unstemmed | Acute myeloid leukemia presenting with hepatic dysfunction: Should induction be dose reduced? |
| title_short | Acute myeloid leukemia presenting with hepatic dysfunction: Should induction be dose reduced? |
| title_sort | acute myeloid leukemia presenting with hepatic dysfunction should induction be dose reduced |
| topic | anthracycline hepatic leukemia myeloid pharmacology |
| url | https://doi.org/10.1002/jha2.979 |
| work_keys_str_mv | AT satishmaharaj acutemyeloidleukemiapresentingwithhepaticdysfunctionshouldinductionbedosereduced AT simonechang acutemyeloidleukemiapresentingwithhepaticdysfunctionshouldinductionbedosereduced |