在儿科急性白血病中,高剂量甲状腺素的分泌延迟与药和便秘管理相关
Jennifer A Belsky1, Ashley Chavana2, Ankona Banerjee2
1Department of Pediatrics, Division of Hematology/Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Pediatric blood & cancer
|October 10, 2024
概括
在儿童急性淋巴细胞白血病 (ALL) 患者接受高剂量甲状腺素 (HD-MTX) 的情况下,用药治疗便秘与延迟药物分泌有关. 这种关联表明需要进一步研究优化这些年轻患者的HD-MTX清除.
科学领域:
- 儿科瘤学 儿科瘤学
- 药理学 药理学是指药理学的学科.
- 临床药房 临床药房
背景情况:
- 在儿科急性淋巴细胞白血病 (ALL) 中,高剂量甲状腺素 (HD-MTX) 的分泌延迟可能导致显著的发病率.
- 虽然主要通过脏分泌,但HD-MTX可能会压倒功能,增加对便排泄通路的依赖.
研究的目的:
- 评估儿童ALL患者在便秘时使用药和延迟分泌HD-MTX之间的关联.
- 确定影响HD-MTX清除的因素以及优化药物分泌的潜在干预措施.
主要方法:
- 对接受HD-MTX (5g/m2) 的儿科ALL患者 (2010-2020年) 的多站点图表综述.
- 延迟排泄,定义为血清MTX>0.4μM在48小时;便秘由输液后≥2剂药代理.
- 多级逻辑回归模型用于计算每个患者的多个MTX周期.
主要成果:
- 在1875个HD-MTX输液中,42.7%的533名患者出现了延迟分泌.
- 接受≥2剂药的患者 (19.9%的输液) 经历延迟排泄的可能性增加了58% (OR1.58;p=0.002).
- 这种关联与其他临床因素保持独立.
结论:
- 至少两剂药的接收独立地与儿科ALL中的延迟HD-MTX分泌有关.
- 进一步的前性研究是有必要的,以确认便秘的作用,并探索优化甲状腺上排泄的策略.
- 了解这些关联可能有助于改善接受HD-MTX治疗的儿科ALL患者的临床结果.
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