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梅尔法兰发烧性中性质衰竭危险因素

Masahiro Yasuda¹, Tomoya Tachi, Tomohiro Osawa

¹Dept. of Pharmacy, Gifu Municipal Hospital.

Gan to kagaku ryoho. Cancer & chemotherapy

|June 15, 2023

概括

在梅尔法兰 (L-PAM) 治疗前乳酸脱酶 (LD) 水平升高显著预测了多发性髓瘤患者发烧性中性质衰竭 (FN) 风险. 对于LD>222 U/L的患者来说,密切监测至关重要,以防止严重的FN.

科学领域:

血液学血液学血液学
在瘤学瘤学.
临床药理学临床药理学

背景情况:

发烧性中性衰竭 (FN) 是化疗的严重并发症.
梅尔法兰 (L-PAM) 经常用于多发性骨髓瘤 (MM).
在L-PAM治疗中确定FN的预测因素对于患者管理至关重要.

研究的目的:

为了确定发烧性中性质衰竭 (FN) 发病的危险因素,在接受梅尔法兰 (L-PAM) 治疗多发性骨髓瘤 (MM) 的患者中.

主要方法:

对39名多发性骨髓瘤患者的回顾性分析,这些患者接受了L-PAM治疗.
在治疗前评估完整血清和肝功能测试.
单变量和多变量逻辑回归分析,以确定FN (3级或更高) 的重大风险因素.

主要成果:

在L-PAM治疗之前,乳酸脱酶 (LD) 水平> 222 U/L被确定为FN发病的重要危险因素.
在LD水平升高的患者中,FN的几率比为6.33 (95% CI:1.12-35.8,p=0.037).
低白细胞计数 (<3.3×103/μL) 在多变量分析中不是一个显著的独立预测因素.

结论:

在治疗前乳酸脱酶 (LD) 水平超过222U/L的患者在梅尔法兰 (L-PAM) 治疗期间患发烧性中性质衰竭 (FN) 的风险显著增加.
在开始L-PAM治疗之前,建议在多发性骨髓瘤患者中密切监测LD水平升高的FN.
这些发现有助于优化患者监测策略,并可能减轻L-PAM治疗患者的FN并发症.

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