Brouwers Elke E M, Huitema Alwin D R, Beijnen Jos H, Schellens Jan H M
Department of Pharmacy & Pharmacology, Slotervaart Hospital/The Netherlands Cancer Institute, Louwesweg 6, 1066 EC Amsterdam, The Netherlands.
BMC Clin Pharmacol. 2008 Sep 17;8:7. doi: 10.1186/1472-6904-8-7.
The aim of this study was to evaluate long-term platinum retention in patients treated with cisplatin and oxaliplatin.
45 patients, treated 8-75 months before participating in this study, were included. Platinum levels in plasma and plasma ultrafiltrate (pUF) were determined. In addition, the reactivity of platinum species in pUF was evaluated. Relationships between platinum retention and possible determinants were evaluated.
Platinum plasma concentrations ranged between 142-2.99 x 10(3) ng/L. Up to 24% of plasma platinum was recovered in pUF. No platinum-DNA adducts in peripheral blood mononuclear cells (PBMCs) could be detected. Ex vivo incubation of DNA with pUF of patients revealed that up to 10% of the reactivity of platinum species was retained. Protein binding proceeded during sample storage. Sodium thiosulfate (STS) appeared to release platinum from the plasma proteins. Platinum levels were related to time, dose, STS co-administration, and glomerular filtration rates (GFR).
Our data suggest that plasma platinum levels are related to time, age, dose, GFR, and STS use. Platinum in plasma, probably, represent platinum eliminated from regenerating tissue. Platinum species in pUF were partly present in a reactive form. The effects of the reactivity on long-term consequences of Pt-containing chemotherapy, however, remains to be established.
本研究旨在评估接受顺铂和奥沙利铂治疗的患者体内铂的长期潴留情况。
纳入45例在参与本研究前8 - 75个月接受过治疗的患者。测定血浆和血浆超滤液(pUF)中的铂水平。此外,评估pUF中铂物种的反应活性。评估铂潴留与可能的决定因素之间的关系。
血浆铂浓度范围为142 - 2.99×10³ ng/L。高达24%的血浆铂在pUF中被回收。在外周血单核细胞(PBMCs)中未检测到铂 - DNA加合物。患者的DNA与pUF进行体外孵育显示,高达10%的铂物种反应活性被保留。在样品储存期间发生了蛋白质结合。硫代硫酸钠(STS)似乎从血浆蛋白中释放出铂。铂水平与时间、剂量、STS联合给药以及肾小球滤过率(GFR)有关。
我们的数据表明,血浆铂水平与时间、年龄、剂量、GFR和STS的使用有关。血浆中的铂可能代表从再生组织中清除的铂。pUF中的铂物种部分以反应性形式存在。然而,这种反应活性对含铂化疗长期后果的影响仍有待确定。