Successful use of high-dose cytarabine in a patient with acute myeloid leukemia and severe hepatic dysfunction

Author:

Barker Jacob A1,Marini Bernard L1,Bixby Dale1,Perissinotti Anthony J1

Affiliation:

1. Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, MI, USA; Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA

Abstract

Acute myeloid leukemia is a hematologic malignancy characterized by the clonal expansion of myeloid blasts in the peripheral blood, bone marrow, and other tissues. Prognosis is poor with 5-year survival rates ranging from 5–65% depending on demographic and clinical features. Outcomes are worse for patients that have an antecedent myeloproliferative neoplasm that evolves to acute myeloid leukemia, with a survival rate of <10%. Treatment for acute myeloid leukemia has remained cytarabine and an anthracycline given in the standard 3 + 7 regimen. However, for patients with liver dysfunction this regimen, among many others, cannot be given safely. There is currently a lack of data regarding the use of cytarabine in patients with severe hepatic dysfunction. In this case report, we present a patient with secondary acute myeloid leukemia who successfully received a modified regimen of high-dose cytarabine while in severe hepatic dysfunction (bilirubin >15 mg/dL).

Publisher

SAGE Publications

Subject

Pharmacology (medical),Oncology

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