Pharmacy Service, Oklahoma City Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma 73104, USA.
Pharmacotherapy. 2010 Sep;30(9):895-903. doi: 10.1592/phco.30.9.895.
To characterize linezolid-associated hematologic toxicities in a large clinical practice setting and to examine the variables associated with development of hematologic toxicities; a secondary objective was to characterize other linezolid-associated toxicities in this population.
Retrospective medical record review.
Academic Veterans Affairs medical center.
Four hundred forty-four patients (mean age 63.7 yrs) who received 544 courses of linezolid from 2004-2007.
Pertinent laboratory data were collected at baseline, periodically throughout each linezolid course, and up to 31 days after discontinuation. The frequencies of grade 1-2 and grade 3-4 thrombocytopenia were 7.6% and 5.2%, respectively. Grade 3-4 anemia developed in 18.8% of courses; each of the patients had baseline grade 1-2 anemia. Linezolid was discontinued because of toxicity in 35 (6.4%) of the 544 courses. Independent variables associated with grade 3-4 thrombocytopenia included a baseline hemoglobin level of less than 10.5 g/dl, presence of immunosuppression, and a baseline platelet count of 50-99.9 x 10(3)/mm(3). Independent variables associated with development of grade 3-4 anemia included presence of a cardiovascular condition, urologic condition, immunosuppression, and a baseline platelet count of 50-99.9 x 10(3)/mm(3). Other toxicities reported with linezolid included diarrhea (6.6% of courses), followed by nausea (4.4%) and vomiting (4.0%).
The overall rates of thrombocytopenia and anemia for patients receiving linezolid were found to be higher than those in phase III clinical trials. This may be attributable in part to the inclusion of patients with comorbidities that were exclusion criteria in the phase III clinical trials. Clinicians should be aware of variables associated with the development of severe thrombocytopenia and anemia in patients receiving linezolid so that they may predict which patients are likely to develop these toxicities and consider potential alternative therapies in those patients.
在大型临床环境中描述利奈唑胺相关血液学毒性，并研究与血液学毒性发展相关的变量；次要目标是描述该人群中其他利奈唑胺相关毒性。
回顾性病历审查。
学术退伍军人事务医疗中心。
444 名（平均年龄 63.7 岁）患者在 2004-2007 年间接受了 544 个利奈唑胺疗程。
在基线时、每个利奈唑胺疗程期间定期收集相关实验室数据，并在停药后 31 天内收集数据。1-2 级和 3-4 级血小板减少症的频率分别为 7.6%和 5.2%。3-4 级贫血发生在 18.8%的疗程中；每位患者基线时均有 1-2 级贫血。由于毒性，544 个疗程中有 35 个（6.4%）停止使用利奈唑胺。与 3-4 级血小板减少症相关的独立变量包括基线血红蛋白水平<10.5 g/dl、存在免疫抑制和基线血小板计数 50-99.9 x 10(3)/mm(3)。与 3-4 级贫血相关的独立变量包括心血管疾病、泌尿科疾病、免疫抑制和基线血小板计数 50-99.9 x 10(3)/mm(3)。报告的其他利奈唑胺毒性包括腹泻（6.6%的疗程）、恶心（4.4%）和呕吐（4.0%）。
接受利奈唑胺治疗的患者血小板减少症和贫血的总体发生率高于 III 期临床试验。这可能部分归因于纳入了 III 期临床试验排除标准的合并症患者。临床医生应了解与接受利奈唑胺治疗的患者发生严重血小板减少症和贫血相关的变量，以便预测哪些患者可能发生这些毒性，并考虑在这些患者中使用潜在的替代疗法。
