在患有急性淋巴细胞白血病的儿童中,重复高剂量甲状腺素相关的严重毒性预测因素
Chane Choed-Amphai1, Jiraporn Khorana2,3,4,5, Lalita Sathitsamitphong1
1Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
概括
同时使用阿米卡辛和低基线尿液pH预测急性淋巴细胞白血病 (ALL) 的儿童高剂量甲状腺素 (HDMTX) 毒性. 识别这些因素是预防ALL治疗期间脏损伤的关键.
科学领域:
- 儿科瘤学 儿科瘤学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性淋巴细胞白血病 (ALL) 是一种常见的儿童癌症.
- 高剂量甲基酸盐 (HDMTX) 是ALL的关键化疗剂.
- HDMTX可能导致严重的毒性,影响治疗结果.
研究的目的:
- 在儿科ALL患者中确定HDMTX相关的严重毒性预后指标.
- 分析与HDMTX毒性相关的人口,临床和治疗因素.
- 建立预防损伤的预测标记.
主要方法:
- 在2016年至2020年期间治疗的61名儿科ALL患者的回顾性评估.
- 使用多变量逻辑回归分析243个HDMTX输液周期.
- 评估因素,包括同时使用药物和基线尿液pH值.
主要成果:
- 严重的HDMTX毒性发生在37.7%的患者和12.3%的周期中.
- 同时使用阿米卡辛是一种独立的风险因素 (aOR = 17.693).
- 较高的基线尿液pH值具有保护性 (aOR = 0.190),pH值<7.0作为最佳预测指标 (AUC = 0.72).
结论:
- 同时使用阿米卡辛和低基线尿液pH值 (<7.0) 是HDMTX诱导的ALL儿童严重毒性的显著预测因素.
- 早期识别这些风险因素对于实施预防策略至关重要.
- 所有确定的毒性事件都是完全可逆的,这凸显了监测和干预的重要性.
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