Influence of CYP2D6 metabolizer status on ondansetron efficacy in pediatric patients undergoing hematopoietic stem cell transplantation: A case series.
Influence of CYP2D6 metabolizer status on ondansetron efficacy in pediatric patients undergoing hematopoietic stem cell transplantation: A case series.
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DOI：
10.1111/cts.13171
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Ramsey LB
中科院分区：
文献类型：
--
作者：
Edwards A;Teusink-Cross A;Martin LJ;Prows CA;Mehta PA;Ramsey LB
化疗引起的恶心和呕吐(CINV)通常发生在造血干细胞移植(HSCT)前接受抗肿瘤药物治疗的患者。恩丹西酮是一种由CYP2D6代谢的5-HT3拮抗剂，是一种用于治疗短期CINV的止吐药物，但一些患者在服用恩丹西酮时仍会出现无法控制的恶心和呕吐。由于恩丹西酮的快速清除，成年的CYP2D6超快速代谢物(Um)患CINV的风险更高，但类似的研究尚未在儿科患者中进行。我们对128例接受HSCT的儿童患者进行了回顾，这些患者接受恩丹西酮预防CINV，并进行了20个等位基因的CYP2D6基因分型和重复检测。收集每个患者从化疗开始到HSCT后7天的呕吐发作次数。队列的平均年龄为6.6岁(范围0.2-16.7岁)，包括3名UM、72名正常代谢者、47名中间代谢者和6名低代谢者。因为ums是有无效风险的人群，所以我们描述了这三个患者的疗程，以及影响呕吐的因素：化疗的致吐性、诊断和恩丹西酮的使用时间。这些病例描述了当患者是已知的CYP2D6 UM时，推荐非CYP2D6代谢性止吐药物(例如格拉司琼)的支持指南，但需要对更大样本的CYP2D6 ums进行儿科研究来验证我们的发现。
Chemotherapy‐induced nausea and vomiting (CINV) is commonly experienced by patients receiving antineoplastic agents prior to hemopoietic stem cell transplant (HSCT). Ondansetron, a 5‐HT3 antagonist metabolized by CYP2D6, is an antiemetic prescribed to treat short‐term CINV, but some patients still experience uncontrolled nausea and vomiting while taking ondansetron. Adult CYP2D6 ultrarapid metabolizers (UMs) are at higher risk for CINV due to rapid ondansetron clearance, but similar studies have not been performed in pediatric patients. We performed a retrospective chart review of 128 pediatric HSCT recipients who received ondansetron for CINV prevention and had CYP2D6 genotyping for 20 alleles and duplication detection. The number of emetic episodes for each patient was collected from the start of chemotherapy through 7 days after HSCT. The average age of the cohort was 6.6 years (range: 0.2–16.7) and included three UMs, 72 normal metabolizers, 47 intermediate metabolizers, and six poor metabolizers. Because UMs are the population at risk for inefficacy, we describe the course of treatment for these three patients, as well as the factors influencing emesis: chemotherapy emetogenicity, diagnosis, and duration of ondansetron administration. The cases described support guidelines recommending non‐CYP2D6 metabolized antiemetics (e.g., granisetron) when a patient is a known CYP2D6 UM, but pediatric studies with a larger sample of CYP2D6 UMs are needed to validate our findings.
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影响因子：
50.5
作者：
Aapro, M. S.;Grunberg, S. M.;Macciocchi, A.
通讯作者：
Macciocchi, A.
DOI：
10.13040/ijpsr.0975-8232.9(4).1644-49
发表时间：
2018-04-01
期刊：
INTERNATIONAL JOURNAL OF PHARMACEUTICAL SCIENCES AND RESEARCH
影响因子：
--
作者：
Innocent, Muhire;Karimi, P. N.;Maranga, I. S. O.
通讯作者：
Maranga, I. S. O.
影响因子：
6.7
作者：
Ramsey, Laura B.;Prows, Cynthia A.;Glauser, Tracy A.
通讯作者：
Glauser, Tracy A.
影响因子：
1.5
作者：
Culver, Mark A.;Richards, Emily C.;Edwards, Christopher J.
通讯作者：
Edwards, Christopher J.
影响因子：
2.9
作者：
Sharma, Ashish;Pibarot, Philippe;Hamelin, Bettina A.
通讯作者：
Hamelin, Bettina A.