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高剂量甲三甲酸诱导口腔粘膜炎的临床危险因素,在个性化剂量后

Zhongbo Hu¹, Andrea M Escalera-Joy², Emily Ashcraft³

¹Hospitalist Medicine Program, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.

Cancer medicine

|November 1, 2024

概括

治疗急性淋巴细胞白血病 (ALL) 的高剂量甲状腺素 (HDMTX) 可能导致口腔粘膜炎. 皮肤皮疹,发烧和中性质减退是儿童这种副作用的关键独立危险因素.

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.
临床医学临床医学

背景情况:

口腔粘膜炎是高剂量甲状腺素 (HDMTX) 在患有急性淋巴细胞白血病 (ALL) 的儿童中常见的副作用.
尽管有个性化剂量策略,但粘膜炎发病率的变化仍然存在,需要进一步调查风险因素.

研究的目的:

为了确定与个性化HDMTX协议治疗的儿童口腔粘膜炎相关的风险因素.
在这个患者群体中探索复发性粘膜炎的预测因素.

主要方法:

对圣朱德儿童研究医院的数据进行了回顾性分析,共进行了16次试验.
1:1病例控制匹配基于年龄,性别,风险分类,免疫类型和甲状腺素疗程.
使用了统计分析,包括McNemar的,Bowker的对称性和Wilcoxon的签名等级测试.

主要成果:

在粘膜炎和皮肤皮疹,发烧,中性衰竭发烧,低绝对中性粒细胞数量,急性损伤 (AKI),延迟甲状腺清除和更高的42小时甲状腺水平之间发现了显著的关联.
粘膜炎的独立预测因素包括皮肤皮疹,发烧和中性质减退.
女性性别和AKI与复发性粘膜炎有关.

结论:

皮肤皮疹,发烧,AKI,甲索特雷克萨特清除延迟和42小时甲索特雷克萨特水平升高是HDMTX诱导的口腔粘膜炎的关键风险因素.
皮肤皮疹,发烧和中性质减退独立预测粘膜炎,而女性性别和AKI与复发有关.

关键词:

急性脏损伤急性脏损伤是什么急性淋巴细胞白血病急性淋巴细胞白血病延迟的甲托雷克萨特清除时间高剂量的甲基甲酸盐.口腔粘膜炎是一种口腔粘膜炎.有关风险因素的风险因素.

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