Abstract: Objective To investigate the effect of different prophylactic liver protection drug regimens on liver injury after first chemotherapy in patients with acute myeloid leukemia. Methods 160 cases of patients with acute myeloid leukemia admitted between January 2015 and December 2017 were collected in our hospital for this prospective study. The patients were divided into control group (40 cases), glutathione (GSH) group (60 cases) and isoglycyrrhizinatel (ISO) group (60 cases). The control group was given chemotherapy only, the GSH group and the ISO group were additionally given GSH and ISO, respectively. The serum levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP), alanine aminotransferase (ALT) and total bilirubin (TBil) pre- and post- chemotherapy were tested. The serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured by enzyme linked immunosorbent assay (ELISA). Meanwhile, the chemotherapy and the drug-induced liver injury of the three groups were analyzed. Results There was no significant difference in the efficacy of chemotherapy among the three groups (P>0.05). The pre-chemotherapy serum levels of AST, ALT, ALP, TBil, IL-6 and TNF-α were comparable (P>0.05) among the three groups. The post-chemotherapy serum level of AST, ALT, ALP and TBil and their changes from baseline of the ISO group were lower than control group and GSH group statistically (P <0.05). The post-chemotherapy serum level of IL-6 and TNF-α of the ISO group were lower than the control group and GSH group significantly (P <0.05); and their changes from baseline were higher than the latter two groups significantly (P<0.05). There were 13 cases (32.50%) and 15 cases (25.00%) of drug-induced liver injury in the control group and GSH group, respectively, without significant (P >0.05) difference between the two groups; while there were 7 cases (11.67%) in the ISO group, which was significantly (P <0.05) lower than the control group and GSH group. Conclusion ISO can improve the liver injury after first chemotherapy in patients with the acute myeloid leukemia, decrease the serum inflammatory factors, so it can play a role in protecting the liver.

Key words: acute myeloid leukemia, drug-induced liver injury, chemotherapy, isoglycyrrhizinatel, glutathione