在儿科白血病患者中,波萨可纳的脑脊液度
Katharina Körholz1, Malcolm Holterhus1, Kathrin Gordon1
1Center for Bone Marrow Transplantation and Department of Pediatric Hematology and Oncology, Infectious Disease Research Program, University Children´s Hospital Münster, Münster, Germany.
The Journal of antimicrobial chemotherapy
|January 10, 2024
概括
脑脊液 (CSF) 中的波萨可纳的最低度很低,但在儿童白血病患者中可以检测到. 血清度保持在目标范围内,表明有效使用的潜力.
科学领域:
- 药理动力学和药物分发
- 儿科血液瘤学
背景情况:
- 关于波萨可纳在中枢神经系统 (CNS) 的分布,特别是大脑组织和脑脊液 (CSF) 的分布存在有限的数据.
- 了解脑脊液中的波萨可纳水平对于优化脆弱儿科群体的抗真菌疗法至关重要.
研究的目的:
- 分析患有急性白血病的儿科患者脑脊液 (CSF) 中的波萨可纳的最低度.
- 评估该患者群体中CSF和血清波萨可纳水平之间的关系.
主要方法:
- 包括患有急性白血病缓解的儿科患者 (<18岁),接受腰部穿刺.
- 在服用后20-24小时内采集脑脊髓和血液样本.
- 使用液体染色学-并联质谱法 (LC-MS/MS) 量化波萨可纳度.
主要成果:
- 在接受治疗的儿科白血病患者 (n=6) 的全部11个脑脊液样本中检测到波萨可纳 (Posaconazole).
- 在CSF中,波萨可纳的度在8.3至42ng/mL之间 (中位数:13.6ng/mL).
- 同时的血清度在965-5177 ng/mL (中位数:1716 ng/mL) 之间,分别在预防和治疗的目标范围内达到100%和90%.
结论:
- 波萨可纳的全身用药导致小儿白血病患者的CSF中低,但可检测的低度.
- 在这些患者中达到的血清波萨可纳水平支持其用于预防和治疗真菌感染.
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