Hepatic toxicity of low doses of mithramycin in hypercalcemia

The medical records of patients receiving mithramycin for the treatment of hypercalcemia at The Johns Hopkins Oncology Center were reviewed. Of 67 evaluable patients, 11 (16%) developed hepatic toxicity when graded using standard criteria. The pattern of laboratory abnormalities noted suggested mild hepatocellular damage that was reversible within 2 weeks. Review of these patients did not identify factors which predispose to hepatic toxicity, although failure to do so may reflect the limited number of toxic patients evaluated. Mild, reversible hepatic dysfunction appears to be a more common sequela of mithramycin administration than has previously been recognized.