Factors influencing the area under the concentration-time curve of mycophenolic acid and adverse drug reactions in children with thalassemia after hematopoietic stem cell transplantation
Objective To determine the factors influencing the area under the concentration-time curve(AUC)of mycophenolic acid(MPA)and the occurrence of adverse drug reactions(ADR)in children with thalassemia after hematopoietic stem cell transplantation(HSCT).Methods Clinical data were collected from pediatric patients with thalassemia after HSCT with monitoring of MPA blood levels from October 2022 to April 2023 in our hospital.The plasma MPA was measured by high-performance liquid chromatography.The MPA-AUC was calculated and information on the occurrence of ADR during the patients'medication was recorded.Multiple regression analysis was used to analyze the factors affecting MPA-AUC and to determine the correlation between ADR and MPA-AUC and the patients'physiological indicators.Results Albumin(ALB)was an independent influence on MPA-AUC in children with thalassemia undergoing HSCT(P＜0.05).The lowest AUC was observed in children with an ALB level＜35 g·L-1,suggesting that hypoproteinemia might affect MPA-AUC,and the lack of hepatic and intestinal circulation in the children resulted in low MPA-AUC.The incidence of ADR in children after the medication was 84.2%,mainly infections.Multiple regression analysis showed a correlation between age and the occurrence of ADR(P＜0.05).Conclusion ALB and lack of hepatic and intestinal circulation affect MPA-AUC.Dose should be increased appropriately for children with ALB＜35 g·L-1.The incidence of ADR after drug administration is fairly high in children,and age is the main influencing factor.Therapeutic drug monitoring is necessary.
hematopoietic stem cell transplantationthalassemiaarea under the concentration-time curvemycophenolic acidinfluencing factor
万方数据
维普
