The importance of Therapeutic Drug Monitoring (TDM) for parenteral busulfan dosing in conditioning regimen for Hematopoietic Stem Cell Transplantation (HSCT) in children

2014 ◽  
Vol 19 ◽  
pp. 214-224 ◽  
Author(s):  
Josef Malis
Keyword(s):  
Stem Cell ◽  
Therapeutic Drug Monitoring ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Drug Monitoring ◽  
Conditioning Regimen ◽  
Therapeutic Drug ◽  
Hematopoietic Stem

scholarly journals Rhino-Orbital-Cerebral Mucormycosis after Allogeneic Hematopoietic Stem Cell Transplantation and Isavuconazole Therapeutic Drug Monitoring during Intestinal Graft versus Host Disease

2019 ◽  
Vol 11 (1) ◽  
pp. e2019061 ◽  
Author(s):  
Giacomo Andreani ◽  
Gianluca Fadda ◽  
Dario Gned ◽  
Matteo Dragani ◽  
Giovanni Cavallo ◽  
...  
Keyword(s):  
Stem Cell ◽  
Therapeutic Drug Monitoring ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Drug Monitoring ◽  
Sinus Surgery ◽  
Therapeutic Drug ◽  
Hematopoietic Stem

  A  diagnosis of rhino-orbital-cerebral mucormycosis was made in a 59-year-old man with a secondary acute myeloid leukemia a few days after hematopoietic stem cell transplantation. Prompt treatment with combined antifungal therapy (liposomal amphotericin B and isavuconazole) followed by a procedure of endoscopic sinus surgery resulted in the resolution of the infection. Therapeutic drug monitoring of isavuconazole was performed during the year of treatment showing an increment of plasma concentrations in correspondence with the improvement of intestinal GvHD, thus suggesting that in this or similar conditions TDM for isavuconazole can be of value. A literature review of cases of rhino-orbital-cerebral and rhino-cerebral mucormycosis in allogeneic hematopoietic stem cell transplant recipients was performed.

scholarly journals Highly Variable Plasma Concentrations of Voriconazole in Pediatric Hematopoietic Stem Cell Transplantation Patients

2012 ◽  
Vol 57 (1) ◽  
pp. 235-240 ◽  
Author(s):  
Imke H. Bartelink ◽  
Tom Wolfs ◽  
Martine Jonker ◽  
Marjolein de Waal ◽  
Toine C. G. Egberts ◽  
...  
Keyword(s):  
Stem Cell ◽  
Therapeutic Drug Monitoring ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Hematopoietic Stem ◽  
Intrapatient Variability

ABSTRACTInvasive fungal infections are of great concern in pediatric hematopoietic stem cell transplantation (HSCT) recipients. Voriconazole is usually the drug of first choice for treating or preventing invasive aspergillosis. Optimum trough levels (Ctroughs) are between 1 and 5 mg/liter. It is unclear whether these levels are reached with currently advised pediatric dosing schedules. Between 2007 and 2011, 11 patients <2 years of age, 31 between 2 and 12 years, and 20 between 12 and 20 years were (prophylactically or therapeutically) treated with voriconazole in the HSCT unit of UMC Utrecht. For children <2 years of age, the dosage recommended for 2 to 12 years was used. In 34% of children who started with the recommended dose, an adequateCtroughwas reached irrespective of age or administration route. After therapeutic drug monitoring (TDM)-based dose adjustments, adequateCtroughs were reached in 80% of the patients at median doses of 31.5 (age, <2 years), 16 (age, 2 to 12 years), and 9.4 mg/kg of body weight/day (age, >12 years) (P= 0.034). The intrapatient variability inCtroughranged between 1 and 238%. Voriconazole was discontinued in six patients due to toxicity. These patients had a medianCtroughof 0.5 mg/liter at the initial dose (ranging from 0.5 to 2.6 mg/liter), and a medium maximal concentration of 4 mg/liter was reached. Inter- and intrapatient variability is a major concern in voriconazole treatment and necessitates therapeutic drug monitoring of dosing, especially in young children.

Sign in / Sign up

Export Citation Format

Share Document