在儿科急性髓性白血病中药物基因组学,种族和治疗结果
Jatinder K Lamba1,2,3, Richard Marrero1, Huiyun Wu4
1Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville.
JAMA network open
|May 16, 2024
概括
增强诱导疗法消除了黑人患者急性髓性白血病 (AML) 结果中的种族差异. 使用药物基因组学量身定制治疗可能会进一步缩小AML存活率的差距.
科学领域:
- 血液学 血液学 血液学
- 儿科瘤学 儿科瘤学
- 临床药理学 临床药理学
背景情况:
- 急性髓性白血病 (AML) 结果的种族差异仍然存在,黑人患者面临着更差的预后.
- 了解治疗强度对这些差异的影响对于公平护理至关重要.
研究的目的:
- 评估儿童AML的诱导疗法强度的变化是否减少基于种族的结果差异.
- 为了研究细胞氨基酸药物基因组学 (ACS10分数) 在基于种族的治疗结果中的作用.
主要方法:
- 从AML02和AML08试验中对86名黑人和359名白人儿科AML患者进行了有效性比较分析.
- 患者接受了标准的低剂量或增强的高剂量cytarabine诱导疗法.
- 赛塔拉宾药基因学10个单核酸变体 (ACS10) 评分与结果的关联,根据种族和治疗组进行了评估.
主要成果:
- 与白人患者 (56%) 相比,接受标准诱导治疗的黑人患者的5年无事件生存率明显较差 (25%).
- 增强诱导疗法消除了种族差异,黑人 (50%) 和白人 (48%) 患者的5年无事件生存率相似.
- ACS10评分影响了标准治疗的结果,但不是增强疗法,后者没有观察到种族差异.
结论:
- 增强诱导疗法有效消除了儿科AML的种族结果差异.
- 药物基因组调整诱导疗法,考虑ACS10分数,显示有可能缩小AML的种族差距.
- 个性化治疗策略是实现儿童AML公平结果的关键.
相关概念视频
Combination Therapies and Personalized Medicine
4.9K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
4.9K
Nonlinear Pharmacokinetics: Role of Transporters
48
A drug's nonlinear kinetics can be influenced by a diverse range of transporter proteins that serve as crucial players in drug distribution. These transporters, found within cells, can enhance or reduce local drug concentrations by facilitating the influx or efflux of drugs. For instance, the expression of xenobiotic transporters can be influenced by factors such as age and gender, potentially impacting the linearity of drug response.
Polymorphisms occurring in drug transporters can alter...
Polymorphisms occurring in drug transporters can alter...
48
Factors Affecting Drug Biotransformation: Biological
145
Biological factors significantly impact drug metabolism, influencing drug clearance, efficacy, and potential toxicity.
Species differences: Variations in enzyme systems across species can cause disparities in drug metabolism. For instance, humans may metabolize certain drugs faster than rodents, altering therapeutic effects.
Strain differences: Genetic variations within a species can result in differing enzyme activity, impacting drug response and toxicity. For example, some mouse strains may...
Species differences: Variations in enzyme systems across species can cause disparities in drug metabolism. For instance, humans may metabolize certain drugs faster than rodents, altering therapeutic effects.
Strain differences: Genetic variations within a species can result in differing enzyme activity, impacting drug response and toxicity. For example, some mouse strains may...
145
Analysis of Population Pharmacokinetic Data
252
Analysis of population pharmacokinetic data involves studying the behavior of drugs within diverse populations to understand their pharmacokinetic parameters. Traditional pharmacokinetic methods typically involve collecting samples from a few individuals and estimating these parameters. While these methods are commonly used, they have limitations in capturing the variability in drug response among individuals or heterogeneous populations. Population pharmacokinetics is employed to address these...
252
Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K
Human Genetics
561
Human genetics provides a profound framework for understanding the interplay between genetic predispositions and human psychology. At the heart of this discipline lies the study of how genes influence physical traits, behaviors, and susceptibility to diseases. Each person carries a unique genetic code that subtly or significantly shapes their psychological and behavioral landscape.
The complex relationship between genetics and psychology is observable through common biological components such...
The complex relationship between genetics and psychology is observable through common biological components such...
561


