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用venetoclax治疗的急性髓性白血病患者应该接受抗真菌预防吗?

Mariana Guarana¹, Marcio Nucci²

¹University Hospital, Universidade Federal do Rio de Janeiro, Brazil.

Leukemia research

|June 16, 2023

概括

由于侵袭性真菌病 (IFD) 发病率低,因venetoclax治疗方案的急性髓性白血病 (AML) 患者可能不需要初级抗真菌预防. 亚类药物相互作用和毒性进一步支持避免在这个AML亚组中的预防.

科学领域:

血液学血液学血液学
传染性疾病传染性疾病
药理学药理学是指药理学的学科.

背景情况:

侵入性真菌病 (IFD) 是急性髓性白血病 (AML) 患者接受密集化疗的重大风险.
标准护理包括针对密集化疗方案的抗菌预防.
在AML患者中抗真菌预防的作用在基于venetoclax的较少密集的治疗方案中还不清楚.

研究的目的:

在接受密集化疗的AML患者中审查IFD的风险因素.
为了评估IFD发病率和风险因素,在使用低甲基化剂和基于venetoclax的治疗方案的患者中.
讨论阿佐尔药物相互作用和毒性,并建议在没有初级抗真菌预防的情况下使用venetoclax治疗AML患者的管理策略.

主要方法:

在AML患者中对IFD风险因素的文献综述.
在各种AML治疗环境中分析IFD发病率.
讨论与醇抗真菌药物相关的药物相互作用和毒性.
对基于venetoclax的治疗方案管理AML患者的当前前前景的审查.

主要成果:

在接受venetoclax治疗的AML患者中,IFD的发病率可能太低,以至于不需要进行初级抗真菌预防.
由于药物相互作用,阿佐尔抗真菌药需要与venetoclax进行剂量调整.
醇使用与肝脏,胃肠道和心脏问题 (QT延长) 等毒性有关.

结论:

在低IFD发病率的环境中,从醇预防中伤害所需的数量可能超过治疗所需的数量.
基于venetoclax的治疗方案的AML患者的管理可能不需要初级抗真菌预防.
在这种患者群体中应考虑IFD管理的替代策略.

关键词:

患有急性白血病的人.这是一种抗真菌药物.骨髓状细胞是什么? 骨髓状细胞是什么?预防预防预防威尼托克拉克斯 (Venetoclax) 是一个属于威尼托克拉克斯的地区.

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