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Blood, 1959, Vol. 14, No. 1, pp. 80-90.
© 1959 American Society of Hematology, Inc.

Hepatitis in Association with Prolonged 6-Mercaptopurine Therapy

SAMUEL K. McILVANIE 1 and JOHN D. MacCARTHY 1

1 Department of Medicine, Rockwood Clinic and the Department of Pathology, Sacred Heart Hospital, Spokane, Washington.

Four patients are presented who developed toxic hepatitis while being treated for leukemia with 6-mercaptopurine and steroids. The onset was rapid and suggested an acute hepatitis with intrahepatic blockage. Pathologic examination of the liver in two patients who expired with hepatitis is presented and the pathology described. In the third autopsied case the hepatitis had resolved while receiving massive steroid therapy, even though the leukemia progressed rapidly when 6-mercaptopurine was withdrawn. Early recognition of the toxic hepatitis becomes especially important whero 6-mercaptopurine is the first drug to be used in the management of the patient with acute leukemia.

Submitted on December 26, 1957
Accepted on July 6, 1958


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