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Population pharmacokinetics of gentamicin in acute lymphoblastic leukemia pediatric patients compared to non-oncology

Hisham S Abou-Auda1, Fatimah Alotaibi1,2, Sary Alsanea3

  • 1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.

Saudi Pharmaceutical Journal : SPJ : the Official Publication of the Saudi Pharmaceutical Society
|April 10, 2024
PubMed

Insights

Gentamicin pharmacokinetics in pediatric acute lymphoblastic leukemia (ALL) patients showed similar volume of distribution and clearance compared to non-ALL patients. Dosing requirements were alike between groups, suggesting no significant pharmacokinetic differences in this population.

Area of Science:

  • Pharmacokinetics and Drug Metabolism
  • Pediatric Oncology
  • Clinical Pharmacology

Background:

  • Gentamicin pharmacokinetics are crucial in special pediatric populations, including those with acute lymphoblastic leukemia (ALL).
  • Previous research suggests ALL patients may have a different volume of distribution for gentamicin compared to non-ALL patients, necessitating further validation.
  • Accurate pharmacokinetic data ensures safe and effective gentamicin dosing in pediatric patients undergoing treatment.

Purpose of the Study:

  • To compare the pharmacokinetic parameters, specifically volume of distribution (Vd) and clearance (Cl), of gentamicin between pediatric patients with ALL and those without.
  • To validate previous findings regarding potential differences in gentamicin Vd and Cl in ALL patients.
  • To inform clinical application and optimize gentamicin dosing strategies in pediatric oncology.

Main Methods:

  • A single-center, retrospective, cross-sectional study involving 115 pediatric patients (1-14 years) receiving intravenous gentamicin.
  • Patients were divided into ALL (n=63) and non-ALL (n=52) groups, with similar baseline characteristics and gentamicin dosing (2.50 mg/kg every 8h).
  • Pharmacokinetic parameters (Vd, Cl) were analyzed alongside covariates including weight, serum albumin, serum creatinine (Scr), creatinine clearance (Clcr), and blood urea nitrogen (BUN).

Main Results:

  • Weight and Clcr were identified as significant covariates for Vd.
  • Significant differences were observed in Scr, Clcr, and BUN between the ALL and non-ALL groups.
  • Despite differences in renal function markers, no statistically significant difference was found in gentamicin's volume of distribution or clearance between pediatric ALL and non-ALL patients.

Conclusions:

  • The study found similar gentamicin dosing requirements for pediatric patients with and without ALL.
  • Volume of distribution and clearance of gentamicin did not significantly differ between the two groups.
  • Further prospective studies with larger sample sizes are recommended to confirm these findings and refine gentamicin dosing guidelines in pediatric oncology.

Keywords:
Acute Lymphoblastic Leukemia (ALL)GentamicinPediatricPharmacokinetics (PK)Therapeutic Drug Monitoring (TDM)

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