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中性衰减与瓦尔甘西克洛维尔预防的关联儿科固体器官移植接受者中的剂量实践

Emma Gerthoffer¹, Amber Pozderac¹, Leanna Darland¹

¹Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Pediatric transplantation

|May 3, 2025

概括

在小儿固体器官移植接受者的瓦尔甘西克洛维尔剂量并没有直接预测中性衰竭. 然而,根据人体表面积和功能调整的剂量与中性质减退风险的增加有关.

科学领域:

药理学药理学是指药理学的学科.
移植医学移植医学移植医学
儿科儿科儿科

背景情况:

在小儿固体器官移植 (SOT) 接受者中,用于细胞巨乳病毒 (CMV) 预防的瓦尔甘西克洛维尔剂量有显著的差异.
中性是这一群体的一个关键不良事件.

研究的目的:

评估瓦尔甘西克洛维尔剂量策略对小儿SOT接受者的中性质衰竭发病率的影响.
评估一种用于估计淋巴膜过率 (GFR) 的新方法.

主要方法:

80名小儿SOT接受者的回顾性图表审查.
回归建模以确定移植后中性质衰竭的预测因素.
用于剂量调整的基于使用的cystatin C估计的GFR.

主要成果:

32.5%的患者在服用瓦尔甘西克洛维尔时出现了中性衰竭.
同时服用骨髓抑制药物是常见的 (硫甲醇-trimethoprim和mycophenolate).
瓦尔甘西克洛维尔剂量 (mg/kg) 不能预测中性质衰竭;然而,根据BSA和功能调整的剂量与中性质衰竭风险增加有关.

结论:

该机构的剂量策略,使用BSA和一种新的GFR方法,导致中性衰竭率低于之前报告的水平.
鉴于功能,瓦尔甘西克洛维尔暴露对于控制中性质衰竭风险至关重要,而不仅仅是mg/kg的剂量.
优化valganciclovir剂量需要仔细考虑个体患者的因素,包括功能.

关键词:

中性变质症中性变质症中性变质症预防预防预防预防实体器官移植实体器官移植瓦尔根西克洛维尔 (Valganciclovir) 是一种药物.

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