在血液学恶性瘤中管理高剂量甲二的毒性策略:从临床病例中吸取教训
Vanessa McLelland1, Martin Guscott2, Matthew R Wilson3
1Bristol Royal Hospital for Children Bristol UK.
Clinical case reports
|February 12, 2026
概括
高剂量的甲状腺素 (HDMTX) 可以导致癌症患者的急性损伤 (AKI). 及时的支持性护理和葡萄糖酶对于管理延迟的甲状腺清除和预防严重毒性至关重要.
科学领域:
- 在瘤学瘤学.
- 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:
- 高剂量甲基酸盐 (HDMTX) 对于治疗各种癌症至关重要.
- HDMTX可以引起严重的不良事件,特别是急性损伤 (AKI).
研究的目的:
- 报告在血液恶性瘤中使用HDMTX的两例病例.
- 突出支持性护理和早期干预对HDMTX毒性的重要性.
主要方法:
- 一个患有NHL的8岁女孩接受HDMTX的案例报告.
- 一名76岁的中枢神经系统原发性淋巴瘤患者接受HDMTX治疗的病例报告.
- 对支持性护理措施和干预措施的审查,以管理HDMTX诱导的毒性.
主要成果:
- 患者1在HDMTX后出现AKI和粘膜炎,需要补水,葡萄糖酶和腹腔营养才能恢复.
- 患者2经历了延迟的MTX清除,液体过载和急性肝损伤,需要长时间的支持性护理.
- 这两种情况都强调了尽管采用标准方案,但仍有可能产生严重的毒性.
结论:
- 预防性支持性护理,包括水分和白素,是必不可少的.
- 警监测和及时服用葡萄糖酶对于管理延迟的MTX清除和预防严重并发症至关重要.
- 个性化患者管理是优化HDMTX治疗结果的关键.
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