用皮和阿斯巴拉基纳斯前期治疗降低过敏反应
Ryan Guerrettaz1, Megan Wegter2, Melodee Liegl3
1Division of Pediatric Hematology/Oncology/Blood and Marrow Transplantation, Medical College of Wisconsin.
Journal of pediatric hematology/oncology
|September 10, 2025
概括
在前期治疗中添加皮醇可显著降低对化大肠杆菌阿斯巴拉金酶 (PEG) 的过敏反应 (HSR). 这种3种药物治疗方案降低了HSR率,改善了白血病和淋巴瘤治疗耐受性.
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:
- 化大肠杆菌阿斯巴拉金酶 (PEG) 对于白血病/淋巴瘤治疗至关重要,但会引起过敏反应 (HSR).
- HSR通常需要切换到Erwinia asparaginase (ERW),从而增加了患者的负担.
- 目前用二胺和 famotidine 进行前期治疗,在预防 HSR 到 PEG 的过程中显示出不同的疗效.
研究的目的:
- 为了评估添加皮素到标准的2种药物前期治疗方案中的有效性,以预防HSR到PEG.
- 为了比较接受2药与3药前期治疗方案的患者之间的HSR和输液反应 (IR) 率.
主要方法:
- 对接受前线PEG.的淋巴细胞恶性瘤患者的回顾性分析.
- 两种药物 (二胺,法莫蒂丁) 治疗方案组与三种药物 (二胺,法莫蒂丁,皮) 治疗方案组的比较.
- 使用CTCAE v5.5对HSR和IR进行独立审查和分级.
主要成果:
- 三种药物治疗方案组 (n=35) 与两种药物治疗方案组 (n=50,38%) (P=0.007) 相比,HSR率显著下降 (11%)
- 输液反应 (IR) 速率在两组之间保持一致 (11%).
- 添加皮导致HSR率降低了25%以上.
结论:
- 将皮松添加到迪芬胺和 famotidine 前期治疗中有效地降低了HSR 到IV PEG.
- 这一策略可以改善治疗的坚持,并减少对ERW等替代疗法的需求.
- 需要进一步的前性研究来证实这些发现.
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