Liver function test.

Hi Bram,

I have had 1 liver function test in the early stages of my CML. I was dx just over 18 months ago. My consultant says that he doesn't feel they are very useful as the results can be so varied and therfore he tends not to do them now when patients seem to be doing ok.

Regards,
Colin

I have an LFT every time I have my bloods done. My dr doesn't give me the results though. He says if they are off then he'll tell me.

Marian

Hi Bram,

It would be best to take a look at the FAQ/Glossary on the main menu.
Go to 'Normal Blood Counts' and scroll down to the Liver Function Tests..... I have copied some info here but take a look for a fuller explanation of why you should get LFT's regularly if you are on long term drug therapy with imatinib/dasatinib/nilotinib.

Sandy

LIVER FUNCTION TESTS:

In addition to monitoring CBCs and blood differentials, it is critical to monitor liver counts through Liver Function Tests (LFTs), a group of blood tests that can help to show how well a person's liver is working. LFTs include measurements of total protein, albumin, various liver enzymes such as ALT and AST, alkaline phosphatase (ALP) and bilirubin.

Total Protein measures the amount of proteins in the bloodstream. Normal total protein levels in the bloodstream range from 6.5 to 8.2 gm/dL (grams per deciliter). Two of the main proteins found in the bloodstream are albumin and globulin.

Albumin is a protein made in the liver. If the liver is badly damaged, it can no longer produce albumin. Albumin maintains the amount of blood in the veins and arteries. When albumin levels become very low, fluid can leak out from the blood vessels into nearby tissues, causing swelling in the feet and ankles. Very low levels of albumin may indicate liver damage. The normal albumin range is from 3.9 gm/dL to 5.0 gm/dL.

ALT and AST are enzymes made in the liver. They are also called transaminases. ALT is sometimes called SGPT and AST is sometimes called SGOT.
The normal range of ALT levels is between 5 IU/L (International Units per Liter) and 60 IU/L.
The normal range of AST levels is between 5 IU/L and 43 IU/L. Elevated liver enzymes may be a sign of hepatotoxicity (liver toxicity).

Alkaline phosphatase (ALP) is another enzyme found in the liver. Abnormally high ALP levels may indicate liver problems. The normal range of ALP is between 30 IU/L and 115 IU/L.

When are abnormal liver function tests (LFTs) cause for concern?
Any abnormalities in LFTs should be addressed and monitored closely.
Current guidelines suggest stopping IM (imatinib) treatment when transaminases (liver enzymes) are more than five times the upper limit of normal.
If liver function begins to return to normal, IM may be resumed at a lower dose, then increased to the prior dose in appropriate cases.

How often should liver function tests (LFTs) be performed?

Because of concerns regarding hepatotoxity with IM treatment, LFTs should be obtained before IM treatment is started, every other week during the first month of IM treatment, and at least monthly thereafter.
Of course, if any indications of liver problems arise, closer monitoring of LFTs is critical.