It is important to note that if you find that your child’s liver enzymes are always easily elevated and the elevation is large, you should be alert for other causes such as hepatitis virus infection, and it is recommended to do a screening for hepatitis virus (including hepatitis A, B, C, D, E) to find the cause for reasonable treatment.
The main treatment for childhood leukemia is chemotherapy, and chemotherapy drugs are very toxic, and while killing leukemia cells, they can also cause damage to various organs of our body, especially damage to the liver is most common, because almost all chemotherapy drugs need to be metabolized and eliminated by the liver, so we need regular liver function monitoring and appropriate liver-protective therapy during the treatment of leukemia.
The more meaningful indicators of liver function damage are bilirubin and transaminases. An increase in bilirubin is more meaningful than an increase in transaminases, which means that if only transaminases are high but not bilirubin, the liver damage is not yet very serious. However, it should be noted that if the child’s red blood cells are destroyed (i.e., hemolysis) during the blood draw, the indirect bilirubin will be significantly elevated, which is not liver damage.
In general, as long as the transaminase does not exceed 400, there is no need to stop chemotherapy drugs. If the bilirubin is not high and the transaminase is within 100, you can use no liver-protective drugs; if the transaminase is within 200, you can use Hepatel (glucuronide) + Mennen (compound glycopyrrolate tablets), or Hepatel + Rituxin (ornithine menthylate). Mennen can be used for 2 weeks, and Hepatel can be taken for a long time. If the transaminases are above 200, there is usually an increase in bilirubin, at which time it is necessary to infuse hepatoprotective therapy for 1-2 weeks, and then take oral hepatoprotective drugs for a period of time.
Among the hepatoprotective drugs, except for Hepatel, all others are also needed for liver detoxification and metabolism, so try not to use hepatoprotective drugs during chemotherapy and do not add more burden to the liver.