[Liver damage during use of busulfan]

A man aged 57 years with a chronic megakaryocytic granulocytic myelosis, treated with an intermittent low-dose busulfan schedule, developed intrahepatic cholestasis. We advise to do liver biopsy, if possible, to differentiate between busulfan hepatotoxicity and leukaemic activity. In the former case, it may be necessary to stop busulfan.