在高风险的扩散性大B细胞淋巴瘤中高剂量甲甲后延迟的甲甲酸消除预防
Masahiro Akimoto1, Takuya Miyazaki1, Hiroyuki Takahashi2
1Department of Hematology, Yokohama City University Medical Center, Japan.
Internal medicine (Tokyo, Japan)
|March 16, 2025
概括
在扩散性大B细胞淋巴瘤 (DLBCL) 中,用于中枢神经系统预防的高剂量甲状腺素 (HD-MTX) 可能会导致延迟排泄. 较短的输液时间,比如3小时,可能会降低这种风险和相关的毒性.
科学领域:
- 在瘤学瘤学.
- 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:
- 高剂量甲状腺素 (HD-MTX) 是中枢神经系统预防高风险扩散型大B细胞淋巴瘤 (DLBCL) 的标准.
- 确保HD-MTX预防的安全性和尽量减少不良事件至关重要.
- 关于HD-MTX在这种特定患者群体中的安全性概况的数据有限.
研究的目的:
- 分析高风险DLBCL患者与HD-MTX相关的不良事件.
- 调查延迟甲状腺素排泄的发生率和影响.
- 确定缓解HD-MTX相关并发症的策略.
主要方法:
- 98名DLBCL患者接受HD-MTX用于中枢神经系统预防的多中心回顾性研究 (2014-2020年).
- HD-MTX在3.0g/m2的2个周期中,分隔2周,进行2次治疗.
- 分析的重点是延迟的MTX消除和相关的毒性.
主要成果:
- 延迟MTX消除的总体发生率为18.4%.
- 经过3小时的MTX输注 (n=50),没有出现延迟排泄.
- 延迟排泄与更高的毒性率相关 (77.8%对26.2%),包括严重的不良事件和功能障碍.
结论:
- 延迟的MTX清除与DLBCL患者的并发症增加有关.
- 较短的MTX输液持续时间,特别是3小时,可能会降低延迟排泄的风险.
- 优化输液协议可以提高中枢神经系统预防的HD-MTX安全性.
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