Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Australia.
Support Care Cancer. 2012 Oct;20(10):2531-5. doi: 10.1007/s00520-011-1377-4. Epub 2012 Jan 15.
Carmustine is a nitrosurea alkylating agent predominantly used at Peter MacCallum Cancer Centre as part of the autologous stem cell transplant induction regimens Stanford BCNU and BEAM. Acute infusion reactions were anecdotally reported to be higher than the reported rates of 10%, and it was suggested that the rate of infusion being employed was excessive. Some references suggest maximum infusion rates of 3 mg/m(2)/min for carmustine, a rate which is exceeded in the 2-h infusions used for Stanford BCNU, but not with BEAM.
A retrospective audit was conducted in 64 patients (57 Stanford BCNU, 7 BEAM) who had received these regimens between January 2009 and November 2010.
Rates of infusion reaction to carmustine were higher than literature values, with reactions in Stanford BCNU (94.7%) being significantly higher than for BEAM (28.6%; P = 0.0003). These findings have resulted in a change of administration of carmustine in Stanford BCNU from 2 to 3 h. Further studies plan to compare the incidence of infusion reactions before and after the change in administration rates.
Patients receiving rapid infusion of carmustine in the Stanford BCNU regimen for stem cell conditioning have a high rate of infusion reaction. A maximum rate of 3 mg/m(2)/min is recommended.
卡莫司汀是一种亚硝脲类烷化剂，主要在彼得麦卡伦癌症中心用作自体干细胞移植诱导方案斯坦福 BCNU 和 BEAM 的一部分。据报道，急性输注反应的发生率高于 10%的报告率，有人认为所用的输注率过高。一些参考文献建议卡莫司汀的最大输注率为 3mg/m²/min，而斯坦福 BCNU 中使用的 2 小时输注超过了这一速度，但 BEAM 则没有。
对 2009 年 1 月至 2010 年 11 月期间接受这些方案治疗的 64 例患者（57 例斯坦福 BCNU，7 例 BEAM）进行了回顾性审计。
卡莫司汀输注反应率高于文献值，斯坦福 BCNU（94.7%）的反应明显高于 BEAM（28.6%；P=0.0003）。这些发现导致斯坦福 BCNU 中卡莫司汀的给药从 2 小时改为 3 小时。进一步的研究计划比较给药速度改变前后输注反应的发生率。
接受斯坦福 BCNU 方案干细胞调理中卡莫司汀快速输注的患者输注反应发生率高。建议最大输注率为 3mg/m²/min。
