培门冬酶治疗淋巴系统肿瘤的安全性分析及处理措施

Safety analysis of pegaspargase in the treatment of lymphatic system tumors and its disposal measures of adverse drug reactions

目的探讨培门冬酶(PEG-Asp)治疗淋巴系统肿瘤的安全性及处理措施。方法回顾性分析2018年10月~2019年10月收治的淋巴肿瘤患者中,选取48例在常规治疗基础上联合培门冬酶进行治疗,观察其临床疗效,记录治疗期间患者不良反应发生情况,并及时给予处理措施。结果48例淋巴肿瘤患者中,NK/T细胞淋巴瘤30例、T淋巴母细胞淋巴瘤12例、B淋巴母细胞淋巴瘤6例。经治疗后,完全缓解19例,占比39.58%;部分缓解14例,占比29.17%;疾病稳定10例,占比20.83%;疾病进展5例,占比10.42%,临床总有效率为68.75%。治疗期间,发生急性胰腺炎7例,占比14.58%;纤维蛋白原异常25例,占比52.08%;转氨酶异常11例,占比22.92%;高血糖43例,占比89.8%;轻微过敏2例,占比4.17%;胃肠道反应及其他不良反应14例,占比29.17%,不良反应发生后及时停药或对症治疗处理后明显改善。结论培门冬酶治疗淋巴系统肿瘤不良反应发生较多,经过积极干预后基本可以得到有效改善或痊愈,且患者耐受情况良好,安全性值得肯定。但治疗时需密切监测患者情况,以确保临床有效性和安全性。

Objective To explore the safety analysis of pegaspargase in the treatment of lymphatic system tumor and its disposal measures of adverse drug reactions.Methods Regression analysis of lymphoma patients admitted from October 2018 to October 2019,48 cases were selected for pegaspargase treatment on the basis of conventional treatment,the clinical efficacy was observed,and the occurrence of adverse drug reactions(ADRs)during the treatment period was recorded,and gave treatment measures of ADRs in time.Results Among the 48 patients with lymphoma,30 were NK/T cell lymphoma,12 were T lymphoblastic lymphoma,and 6 were B lymphoblastic lymphoma.After treatment,19 cases had complete remission,accounting for 39.58%;14 cases had partial remission,accounting for 29.17%;10 cases of stable disease,accounting for 20.83%;5 cases of disease progression,accounting for 10.42%,and the total clinical effective rate was 68.75%.During treatment,7 cases of acute pancreatitis occurred,accounting for 14.58%;25 cases of fibrinogen abnormality,accounting for 52.08%;11 cases of transaminase abnormality,accounting for 22.92%;43 cases of hyperglycemia,accounting for 89.8%;mild allergy 2 Cases,accounting for 4.17%;14 cases of gastrointestinal reactions,accounting for 29.17%,Stop the drug in time when serious adverse reactions occurred.When the adverse reactions occurred,they all improved after symptomatic treatments such as inhibition of pancreatic secretion,hypoglycemic,lipid reduction,plasma supplementation,and anti-allergic treatment.Conclusion There are many adverse reactions of pegaspartase in the treatment of lymphatic system tumors,most of which can be effectively improved or recovered after active intervention,and the patients are well tolerated,and the safety is worthy of affirmation.However,patients need to be closely monitored during treatment to ensure clinical effectiveness and safety.