High Liver ALT and AST

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High Liver ALT and AST

Postby Prop321 » Wed Oct 18, 2017 10:01 pm

Hi, my wife has rectal cancer and has completed her neoadjuvant chemoradiotherapy and surgery.

She is was supposed to have her 4th Xelox on Wednesday but the oncologist postponed as her liver function test
ALT (125 U/L vs <55norm) and AST (77 vs <34norm) are very high.
She will re-do the blood test tomorrow.
Depending on result tmrw, oncologist say either reduce dosage or postpone Xelox.

Anyone has similar experience and what was the follow-up process?

Many thanks in advance.

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Re: High Liver ALT and AST

Postby Achilles Torn » Thu Oct 19, 2017 8:59 am

Near the end of my first 12 cycles of FolFox my ALT was 144 and my AST 103. My Onc considered them elevated but wasn’t overly concerned and I didn’t miss chemo because of it. Both went back down to near normal after Oxi was cut out. Chemo is very hard on the liver which should recover after a short break.

Hope that helps
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Re: High Liver ALT and AST

Postby mariane » Thu Oct 19, 2017 11:51 am

I had AlAT and AspAT around 400-500 during FOLFOX and FUDR given together during my treatment. My oncologist switched oxaliplatin with irinotecan and my AlAT, AspAT came back to 30-50. I received in all 8 FOLFIRI. Now they are in low 20 even less than 20.
AlAT and AspAT show inflammation, damage of hepatic cells. Hepatic cells regenerate very quickly and easily.
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4 surgeries, complete pathological response
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Re: High Liver ALT and AST

Postby kandj » Fri Oct 20, 2017 3:48 pm

DH has never had his chemo cancelled due to liver functions being high and his are over those numbers regularly. I was told that it was when they see them in the 5-6x the normal values that they worry. He has had the FUDR in his liver pump cancelled due to high ALP though.
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Re: High Liver ALT and AST

Postby MissMolly » Fri Oct 20, 2017 5:11 pm

Your liver enzyme levels are not a reason for concern.

I have had AST and ALT values in the low 1,000’s due to medication interaction affects. Only when the AST asks ALT values elevated into the range of 1,100 - 1,200 did my physicians become concerned.

The range of “normal” for interpretation of blood chemistry values (ex. Complete blood count or complete metabolic panel) is derived from a statistical model and bell curve that includes a large swath of population parameters to determine cut off values. Thousands (and thousands) of data points are used to establish lab ranges for each enzyme or electrolyte curried in a blood test. Lab values, as such, reflect population statistics more than individual statistics.
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Re: High Liver ALT and AST

Postby CRguy » Fri Oct 20, 2017 7:12 pm

Your liver enzyme levels are not a reason for concern.

I generally concur with the above quote and explanation from Karen .... BUTT

1. your LiverZymes levels are appropriate for your situation ... i.e. chemo related
2. often trends are more important than singular absolute values
3. in quoting references, we need to allow for different lab ranges and testing methodologies, which may NOT be universal for every lab or every patient on this forum.
4. YOU need to have a baseline of these levels for YOUR OWN situation, in order for the test results to be meaningful, descriptive and predictive.
5. NEVER rule out the possibility of lab errors ! ( been doing this 36 years ... AND IT DOES HAPPEN ! )
6. be mindful of reporting errors ... i.e. somewhere along the human "paper" trail a wrong comment or wrong result ends up in your file !

SO ... I would not personally sweat the lab results just yet ... BUTT I would be vigilant and pro-active in talking with the Docs to be sure you are getting all the info correctly.


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Re: High Liver ALT and AST

Postby Prop321 » Sat Oct 21, 2017 6:06 am

Many thanks for the feedback and advice.
Yesterday my wife's blood test ALT and AST was still high. The oncologist referred my wife to liver specialist. Untrasound scan was done and the liver look ok.
The liver specialists asks my wife to return in a week to re check the AST and ALT, and if levels drop, then my wife may continue Xerox.

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