Ursodeoxycholic acid and ademethionine as an effective combination for the anthracycline-induced liver injury treatment

Abstract

The primary method of acute leukemia treatment is the program polychemotherapy (PCT), including anthracycline antibiotics. Liver injuries on the PCT background are the limiting factor for the PCT in its entirety. The anthracycline antibiotics use is associated with the risk of drug-induced liver injury (DILI) development. The aim of study is to improve the effectiveness of treatment of the anthracycline-induced DILI through the development of new pharmacological complexes. We examined 54 patients with acute myeloid leukemia, who developed DILI in the PCT dynamics. Results: The increased alkaline phosphatase (ALP) activity, gamma-glutamyl transpeptidase (GGT), bilirubin, ALT, AST was found on the PCT background compared with healthy. While the argynase blood activity decreased and the concentration of the average weight molecules (AWM) increased. After 30 days of treatment the ALP, GGT, total bilirubin, ALT and AST activity decreased. At the 56th -60th days of treatment the cytolytic and cholestatic syndromes parameters normalized in 44 (81.5%) pts. The argynase activity increased on the background of decreased the AWM level, reflecting the increased detoxication processes. This allows conducting PCT in full compliance with cytostatics administration regimen. Conclusion: Thus, the combination of UDCA and ademethionine in high doses is optimal approach to treatment and prevention of DILI, induced by anthracyclines.