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Question about liver health & TKIs: Mildly-elevated bilirubin

liver gleevec bilirubin

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#1 LivingWellWithCML


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Posted 16 August 2014 - 03:17 PM

Hi everyone,


I really haven't paid attention to my liver function numbers (which is included with each Complete Metabolic Panel), and my CML specialist never calls it out.  I just figured that my liver handles Gleevec without undo stress.  However, I decided to look back and I have a trend of total bilirubin >= 1.2 that has persisted for quite some time - actually, for most of my CML journey!  Prior to and a few months following diagnosis in 2011, my bilirubin was a comfortable 0.8, but then it jumped into this 1.2+ range and it looks like it's been at that higher level ever since.  The 2.0 from my bloodwork last week really caught my eye - yikes.


I'm not on any other daily medications ... just the occasional Aleve for inflammation/sports, and a moderate red wine routine (1 - 2 small glasses most nights).  My other liver function counts are normal.


Do any others of you have a pattern of high-normal and/or mildly-elevated bilirubin, and if so, what does your oncologist think about it?  Is this a sign of liver stress that I need to have examined further?


Thanks for any insights!


                              4/2013           10/2013               1/2014            4/2014        8/2014

Bilirubin Total          1.2                  1.7                        1.2                  1.2              2.0

AST                          27                   37                         88                   32               30

ALT                           14                   20                         41                   17               15

AP                             53                   44                         59                   50              47

Albumin                    4.5                   4.5                       4.7                   4.7              4.7




Dan - Atlanta, GA

CML CP Diagnosed March 2011

Gleevec 400mg

#2 Trey


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Posted 17 August 2014 - 01:33 PM

I would be more concerned if your ALT and AST had continued higher, but it decreased nicely.  This shows how the high ALT and AST can be temporary and caused by the drug itself.  Bilirubin is less useful as an indicator, but monitor it for future trends.

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