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Most hepatotoxicity secondary to chemotherapy is idiosyncratic.
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Preexisting abnormal liver function has been shown to increase the risk of hepatotoxicity, especially patients with chronic hepatitis B.
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Alterations in the patterns of abnormal liver test are helpful to characterize the type of presentation, but not the extent of damage.
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Presentations include hepatocellular injury, cholestasis, hepatic sinusoidal obstruction syndrome, and progressive liver fibrosis.
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Outcomes can range from asymptomatic
Chemotherapy-Induced Hepatotoxicity
Section snippets
Key points
Antimetabolites
Their mechanism of action is to affect both DNA and RNA synthesis and lead to apoptosis of cells. These drugs have variable hepatotoxic potential and because most are metabolized by the liver, they require dose adjustments in patients with hepatic dysfunction.
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