ALT is also called SGPT (serum glutamic pyruvic transaminase). When doctors talk about "liver functions," they are usually referring to tests on blood samples that measure liver damage. If the chemotherapy is proving to be toxic to your childs liver, the damaged liver cells release an enzyme called ALT into the blood serum. ALT levels can go up in the hundreds or even thousands in some children on chemotherapy. Each institution and protocol has different points at which they decrease dosages or stop chemotherapy to allow the childs liver to recover. If you notice a change in your childs ALT, ask for an explanation and plan of action. (For example: "Johns ALT is now 450. What is your plan to reduce or stop the chemotherapy to allow his liver to recover?")
I was very interested in my daughter's blood counts throughout her treatment. I also tried to get information without making people mad. If I asked a question and received an unsatisfactory answer, I would reply in a nice way: "I am worrying about this and would really appreciate a few minutes of your time to explain it to me." I found the attendings and clinic director to be the most willing to provide explanations. If you get a ridiculous reply (once a fellow patted me on the head and said, "It's our job to think about these things, not yours"), go find someone else to ask.
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