药剂师对高剂量甲状腺管理和淋巴瘤患者急性损伤风险减轻的看法:来自全国调查的结果
Elizabeth B King1, Mikhaila L Rice2, Huong L Truong1
1Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.
Journal of pharmacy practice
|February 20, 2026
概括
药剂师在管理高剂量甲状腺素 (HDMTX) 毒性在淋巴瘤患者中表现出多样化的做法. 关键问题包括功能估计,AKI风险值和葡萄糖酶使用障碍.
科学领域:
- 瘤学 药房 药房
- 药物治疗 药物治疗
- 临床实践 临床实践
背景情况:
- 关于药剂师在淋巴瘤中高剂量甲状腺素 (HDMTX) 毒性管理的实践的现有数据有限.
- 需要了解当前的HDMTX治疗方法及其相关的毒性.
研究的目的:
- 描述目前的药剂师实践和偏好,以预防和管理HDMTX毒性.
- 为了识别血液学/瘤学药剂师之间的态度和方法的变化.
主要方法:
- 对116名血液学/瘤学药剂师进行了基于网络的横截面调查.
- 用于分析的描述性统计和比较测试 (奇平方,费舍尔精确,克鲁斯卡尔-瓦利斯).
- 评估了对功能估计,AKI风险值和支持性干预措施的偏好.
主要成果:
- 考克克罗夫特-高尔特公式是估计功能 (61%) 的首选方法.
- 药剂师继续使用HDMTX,直到AKI风险超过50% (一般) 或20% (第2/3阶段).
- 对于高AKI风险的首选干预措施存在异质性;葡萄糖酶的使用受到成本和未知的最佳剂量限制.
结论:
- 对于淋巴瘤中HDMTX管理的支持性护理实践和信念存在显著的异质性.
- 目前的做法缺乏标准化,强调需要基于证据的指导方针.
- 需要对生物标志物进行进一步的研究,并优化使用诸如葡萄糖酶等干预措施.
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