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Elevated ALT

carolinagirl811
Posts: 15
Joined: Feb 2015

hi all,

I'm currently in maintenance treatment for t-cell lymphoblastic lymphoma and I'll wrap up in May. Today when I went to clinic for chemotherapy and bloood counts, my ALT was very elevated. My doctors did not even mention it, but I'm concerned because I've read it's elevated in people with blood cancers when the cancer is going to progress AND I have read it can be indicative of liver disease. Does anyone know anything?

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3469
Joined: May 2012

Carolina,

ALT and AST are of course liver enzymes. They elevate when the liver is stressed, and it is not uncommon for them to remain high throughout chemo. They also can indicate alcohol use and liver disease. When an irritant is removed, their numbers drift down only very slowly; they do not usuay react fast.  My levels for both were way up throughout treatment and the oncologist never commented on it at all, and would not even take me off Loritabs, which contained Tylenol, which is a serious liver irritant.

You do not say what 'seriously elevated' is, but my GP told me once that most internal medicine doctors do not worry about ALT/AST reading unless they are '2 or 3 times higher than high-normal values.'

Ask your oncologist, but I doubt it is cause for concern.

po18guy
Posts: 1069
Joined: Nov 2011

Blood numbers that would normally land you in the Intensive Care Unit at the hospital are routine in cancer therapy. For that reason, doctor may not have mentioned it. However, simply ask and I am certain that you will be comforted by the answer. My blood creatinine levels have been substantially elevated for more than a year - such that in a "normal" person, kidney failure would be suspected. But, it's all an expected by-product of immune suppression post-transplant. 

PBL
Posts: 222
Joined: Jul 2016

Hello Carolinagirl,

About halfway through chemotherapy, my AST and ALT levels had reached more than double the maximum normal values (and remained double-to-triple normal for a couple of months after chemo had ended) and, as stated by Max, no one even raised an eyebrow. Then, a few months out of chemo, they suddenly shot up to five times max normal values, and that caused some concern. My liver enzymes were closely monitored for a while after that, and quickly went back down (well within normal range) after this episode. As it turns out, it wasn't liver damage, but most likely the result of a ten-day course of a well-known anti-inflammatory prescribed by my GP for an acute case of back pain...

Since - if I read you correctly - you say you are nearing the end of your maintenance treatment and this liver enzyme elevation seems to have happened out of the blue, may I suggest you look back at any medication (even seemingly inoffensive over-the-counter stuff or herbs can be too much for an already-strained liver) you may have started using in the weeks leading to that blood test. And of course, ask your oncologist what s/he thinks.

Chances are, there is no cause for alarm at all.

PBL

carolinagirl811
Posts: 15
Joined: Feb 2015

Thanks you guys! My therapist wants me to call tomorrow to relieve some of my anxiety, but I'm sure it's nothing. 

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