The structure of viral hepatitis and dynamics of cytolitic syndrome in patients with oncohaematological diseases

Abstract

The aim of the research. Evaluation of the structure of viral hepatitis in patients with oncohaematological diseases and activity of ALT and AST during various methods of treatment of the main disease.Materials and methods. Retrospective analysis of data from 2000 patients treated during 2001–2014 in Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and Transplantation Pavlov of the First Saint Petersburg State Medical University was carried out. The dynamics of cytolytic enzymes during therapy (polychemotherapy, transplantation of hematopoietic stem cells, symptomatic) of oncohematological diseases was evaluated between the patients with concomitant chronic viral hepatitis (N=175) and without liver pathology (N=203). Analysis was performed with SAS software. Results. Over a 10-year follow-up period, 9% of the oncohematological patients of the specialized center identified markers of hemocontact viral hepatitis. The results of the study showed that in patients with concomitant viral hepatitis, in contrast to a group without hepatitis the activity of ALT and AST significantly increased compared to baseline values after the treatment of hematological malignancy. It was twofold increase of the activity of enzymes after transplantation of hematopoietic stem cells and 3–4- fold incease after courses of polychemotherapy. In patients without viral hepatitis, changes in enzyme activity after such therapy were not observed. Summary. Thus, the associated effect of concomitant viral hepatitis and toxic effects of treatment methods with the use of polychemotherapy and transplantation of hematopoietic stem cells was proven on the development of cytolytic syndrome in oncohematological patients.

Keywords

• вирусные гепатиты
• цитолитический синдром
• онкогематологические заболевания
• трансплантация гемопоэтических стволовых клеток
• полихимиотерапия.