Τίτλος:
Dose individualization of intravenous busulfan in pediatric patients undergoing bone marrow transplantation: Impact and in vitro evaluation of infusion lag-time
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objectives: To apply therapeutic drug monitoring and dose-individualization of intravenous Busulfan to paediatric patients and evaluate the impact of syringe-pump induced Busulfan infusion lag-time after in vitro estimation. Methods: 76 children and adolescents were administered 2 h intravenous Busulfan infusion every 6 h (16 doses). Busulfan plasma levels, withdrawn by an optimized sampling scheme and measured by a validated HPLC-PDA method, were used to estimate basic PK parameters, AUC, Cmax, kel, t1/2, applying Non-Compartmental Analysis. In vivo infusion lag-time was simulated in vitro and used to evaluate its impact on AUC estimation. Key findings: Mean (%CV) Busulfan AUC, Cmax, clearance and t1/2 for pediatric population were found 962.3 μm × min (33.1), 0.95 mg/L (41.4), 0.27 L/h/kg (33.3), 2.2 h (27.8), respectively. TDM applied to 76 children revealed 6 (7.9%) being above and 25 (32.9%) below therapeutic-range (AUC: 900-1350 μm × min). After dose correction, all patients were measured below toxic levels (AUC < 1500 μm × min), no patient below 900 μm × min. Incorporation of infusion lag-time revealed lower AUCs with 17.1% more patients and 23.1% more younger patients, with body weight <16 kg, being below the therapeutic-range. Conclusions: TDM, applied successfully to 76 children, confirmed the need for Busulfan dose-individualization in paediatric patients. Infusion lag-time was proved clinically significant for younger, low body-weight patients and those close to the lower therapeutic-range limit. © The Author(s) 2021.
Συγγραφείς:
Neroutsos, E.
Athanasiadou, I.
Paisiou, A.
Zisaki, K.
Goussetis, E.
Archontaki, H.
Tsirigotis, P.
Kitra, M.
Grafakos, S.
Spyridonidis, A.
Dokoumetzidis, A.
Valsami, G.
Περιοδικό:
The Journal of pharmacy and pharmacology
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
busulfan; busulfan; immunosuppressive agent, adolescent; adult; area under the curve; Article; blood sampling; body weight; bone marrow transplantation; child; dose individualization; drug blood level; drug monitoring; female; groups by age; high performance liquid chromatography; human; in vitro study; in vivo study; individualization; infant; major clinical study; male; maximum concentration; retrospective study; age; blood; dose response; drug monitoring; intravenous drug administration; pediatrics; preschool child; procedures; young adult, Administration, Intravenous; Adolescent; Adult; Age Factors; Area Under Curve; Body Weight; Bone Marrow Transplantation; Busulfan; Child; Child, Preschool; Dose-Response Relationship, Drug; Drug Monitoring; Female; Humans; Immunosuppressive Agents; Infant; Infusions, Intravenous; Male; Pediatrics; Young Adult
