Influential factors of voriconazole trough concentration and AUC in pediatric patients with thalassemia undergoing hematopoietic stem cell transplantation
OBJECTIVE To analyze the influential factors on trough concentration(cmin)and area under the drug concentration time curve(AUC)of voriconazole(VRZ)in pediatric patients with thalassemia undergoing hematopoietic stem cell transplantation(HSCT).METHODS A total of 60 pediatric patients with thalassemia undergoing HSCT who used VRZ for prevention or treatment of invasive fungal infection were collected in our hospital from January 2021 to January 2024.The plasma concentration of VRZ was measured by high-performance liquid chromatography and the AUC was calculated.The factors affecting cmin and AUC of VRZ were analyzed using multiple linear regression.RESULTS A total of 120 cases of VRZ cmin in 60 pediatric patients was obtained and 27 cases of VRZ AUC in 26 pediatric patients were obtained.The median concentration of VRZ cmin was 0.31 mg/L;46 cases had a cmin in 0.5-5 mg/L(38.33％),2 cases had a cmin＞5 mg/L(1.67％),and 72 cases had a cmin＜0.5 mg/L.The median AUC of VRZ was 11.68 mg-h/L.The patient's body weight,HSCT postoperative days,lymphocyte count,and combined use of phenytoin sodium,tacrolimus or cyclosporine had significant effects on VRZ cmin(P＜0.05).Lymphocyte count and combined use of phenytoin sodium had significant effects on VRZ AUC(P＜0.05).CONCLUSIONS The body weight,HSCT postoperative days,lymphocyte count,and combined use of phenytoin sodium,tacrolimus or cyclosporine are independent factors affecting VRZ cmin.Lymphocyte count and combined use of phenytoin sodium are independent factors affecting VRZ AUC.
voriconazolethalassemiahematopoietic stem cell transplantationplasma concentrationtrough concentrationarea under the drug concentration-time curveinfluential factors
万方数据
维普
