目的分析利奈唑胺致黑毛舌不良反应(ADR)的发生情况及临床特点,为临床合理用药提供参考。方法检索中国知网(CNKI)、中文科技期刊数据库(维普)、万方数据库、Cochrane图书馆、PubMed、Web of Science、Springer link、EmBase、Scopus等...目的分析利奈唑胺致黑毛舌不良反应(ADR)的发生情况及临床特点,为临床合理用药提供参考。方法检索中国知网(CNKI)、中文科技期刊数据库(维普)、万方数据库、Cochrane图书馆、PubMed、Web of Science、Springer link、EmBase、Scopus等数据库中收载的利奈唑胺致黑毛舌不良反应文献进行统计分析,检索时间为2000年1月至2022年5月。结果检索到20篇共26例关于利奈唑胺致黑毛舌不良反应的病例报道,以男性为主(18例,69.23%);20岁以下患者11例(42.31%),52岁以上患者10例(38.46%);黑毛舌出现的时间主要集中在开始用药后的10~14 d左右;大部分患者在停药并给予适当的口腔护理后7~30 d舌部完全恢复正常。结论儿童青少年和中老年患者使用利奈唑胺应尤为注意,避免长期用药,用药过程中注意口腔护理,以减少黑毛舌不良反应的发生。展开更多
Delayed elimination of methotrexate(MTX) is a major clinical concern in patients receiving high-dose MTX(HD-MTX) therapy. In the present study, we aimed to retrospectively explore the factors associated with MTX conce...Delayed elimination of methotrexate(MTX) is a major clinical concern in patients receiving high-dose MTX(HD-MTX) therapy. In the present study, we aimed to retrospectively explore the factors associated with MTX concentrations and elimination delay in pediatric patients with hematological malignancies. Cycles of HD-MTX therapy were categorized into the normal elimination group and delayed elimination group according to the serum MTX concentrations at 24(C) or 42 h(C) after the start of MTX therapy. Clinical characteristics associated with MTX concentrations and elimination delay were assessed by χ^(2) test, Fisher’s exact test, Mann-Whitney test, or Spearman’s correlation coefficient. Generalized Estimating Equations(GEE) were used to adjust for the clustering effects of multiple cycles in one patient and confounders. A total of 43 patients with 138 cycles of HD-MTX chemotherapy were included and evaluated in the current study. Dose, white blood cells(WBC), hemoglobin(HB), and blood urea nitrogen(BUN) were significantly correlated with MTX C(all P < 0.05). No significant correlations were noticed between baseline characteristics and MTX C. Delayed MTX elimination was observed in 34(24.6%) courses. Dose, WBC, HB, BUN, and concurrent infection were the significant risk factors for delayed MTX elimination(all P < 0.05). Our study identified several risk factors associated with MTX levels and elimination, which might be used to recognize patients with a high risk of delayed MTX elimination. However, the findings need to be confirmed in further large-scale studies.展开更多
基金National Natural Science Foundation of China (Grant No. 81872926 and No. 81503135)Beijing Municipal Administration of Hospitals’ Youth Programme (Grant No. QML20160703)+1 种基金Enhancement Fun ding of Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use (BZ0439)Science and Technology Fund of Beijing Shijitan Hospital (Grant No. 2017-c01)。
文摘Delayed elimination of methotrexate(MTX) is a major clinical concern in patients receiving high-dose MTX(HD-MTX) therapy. In the present study, we aimed to retrospectively explore the factors associated with MTX concentrations and elimination delay in pediatric patients with hematological malignancies. Cycles of HD-MTX therapy were categorized into the normal elimination group and delayed elimination group according to the serum MTX concentrations at 24(C) or 42 h(C) after the start of MTX therapy. Clinical characteristics associated with MTX concentrations and elimination delay were assessed by χ^(2) test, Fisher’s exact test, Mann-Whitney test, or Spearman’s correlation coefficient. Generalized Estimating Equations(GEE) were used to adjust for the clustering effects of multiple cycles in one patient and confounders. A total of 43 patients with 138 cycles of HD-MTX chemotherapy were included and evaluated in the current study. Dose, white blood cells(WBC), hemoglobin(HB), and blood urea nitrogen(BUN) were significantly correlated with MTX C(all P < 0.05). No significant correlations were noticed between baseline characteristics and MTX C. Delayed MTX elimination was observed in 34(24.6%) courses. Dose, WBC, HB, BUN, and concurrent infection were the significant risk factors for delayed MTX elimination(all P < 0.05). Our study identified several risk factors associated with MTX levels and elimination, which might be used to recognize patients with a high risk of delayed MTX elimination. However, the findings need to be confirmed in further large-scale studies.
