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联合用药对大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病安全性影响的研究进展
孙会静,韦思柔,代 艳(综述),陈晓宇(审校)
530021 南宁,广西壮族自治区人民医院(广西医学科学院)药学部(孙会静,韦思柔,陈晓宇),儿科(代 艳)
摘要:
[摘要] 甲氨蝶呤是二氢叶酸还原酶抑制剂,临床上常用大剂量甲氨蝶呤冲击疗法预防性治疗髓外白血病。在临床中,大剂量甲氨蝶呤常与其他药物合用,如抗菌药物、质子泵抑制剂、非甾体抗炎药等,可能导致甲氨蝶呤体内药代动力学改变,影响甲氨蝶呤用药安全性。近年来多个案例报道甲氨蝶呤排泄延迟与联合用药有一定的相关性。该文对联合用药对大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病安全性影响的研究进展作一综述。
关键词:  甲氨蝶呤  急性淋巴细胞白血病  联合用药  研究进展
DOI:10.3969/j.issn.1674-3806.2023.08.22
分类号:R 969
基金项目:广西卫生健康委科研课题(编号:Z20190278)
Research progress in effects of combined drugs on the safety of high-dose methotrexate in treatment of acute lymphoblastic leukemia in children
SUN Hui-jing, WEI Si-rou, DAI Yan, et al.
Department of Pharmacy,the People′s Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences), Nanning 530021, China
Abstract:
[Abstract] Methotrexate(MTX) is a dihydrofolate reductase inhibitor, and high-dose MTX shock therapy is commonly used in clinical preventive treatment of extramedullary leukemia. In clinical practice, high-dose MTX is often combined with other drugs, such as antibacterial drugs, proton pump inhibitors and non-steroidal anti-inflammatory drugs, which may lead to pharmacokinetic changes in MTX and affect the safety of administration of MTX. In recent years, a certain correlation between the delayed elimination of MTX and the co-administration of MTX has been reported in several cases. In this paper, the effects of combined drugs on the safety of high-dose MTX in treatment of acute lymphoblastic leukemia in children are reviewed.
Key words:  Methotrexate(MTX)  Acute lymphoblastic leukemia(ALL)  Combined drugs  Research progress