在儿童干细胞移植接受者的真实世界Posaconazole药理动力学数据
Csaba Kassa1, Katalin Csordás1, Lídia Hau1
1Department of Pediatric Hematology and Stem Cell Transplantation, National Institute of Hematology and Infectious Diseases, South-Pest Central Hospital, 1097 Budapest, Hungary.
Children (Basel, Switzerland)
|May 1, 2025
概括
在儿科干细胞移植患者中,波萨可纳的剂量因配方和年龄而异. 较高的波萨可纳水平与突破性真菌感染的减少相关,这表明暴露-反应关系.
科学领域:
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 侵入性真菌病对所有原性造血干细胞移植 (alloHSCT) 接受者构成重大风险.
- 波萨可纳是这种脆弱人群中一种关键的抗真菌预防剂.
研究的目的:
- 为了评估现实世界的波萨可纳低谷水平在儿科 alloHSCT患者.
- 确定最佳的波萨可纳剂量策略,并确定影响药物水平的因素.
- 评估波萨可纳暴露与突破性真菌感染之间的关系.
主要方法:
- 对102名儿科alloHSCT接受者的回顾性,单心研究.
- 对548个血样本进行分析,以检测波萨可纳的度.
- 评估影响药物水平的因素以及与突破性感染的关联.
主要成果:
- 达到目标波萨科纳水平 (0.7-2.0 mg/L) 的每日必要剂量为15.22 (悬浮剂),7.52 (片剂) 和7.84 mg/kg (IV).
- 年轻的患者 (<13岁) 需要更高的剂量.
- 肠道症状与较低水平相关;PPI没有显著影响水平.
- 低水平的波萨可纳 (<0.7 mg/L) 与突破性感染有关;较高水平降低了感染风险.
结论:
- 波萨可纳片和静脉注射配方提供了比悬浮剂更可预测的水平.
- 波萨可纳水平和儿科allHSCT患者突破性真菌感染风险之间存在暴露-反应关系.
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