Hepatotoxicity Associated with Arsenic Trioxide Chemotherapy

Agent: Arsenic trioxide (As2O3)

The hepatotoxicity with standard doses is usually mild and temporary. It is typically observed from the first to third week after the chemotherapy. Severe and fatal hepatotoxicity can occur. Improvement in liver function tends to occur after stopping the drug.

Manifestations of hepatotoxicity:

(1) elevation of serum AST and ALT

(2) elevation of serum GGT

(3) hepatomegaly

Risk factors for hepatotoxicity:

(1) differentiation syndrome

(2) high dose

(3) homozygous MTHFR 1298 (CC)

(4) GST (glutathione S-transferase) M1 null phenotype