Bodge Megan N, Reddy Srividya, Thompson Michael Scott, Savani Bipin N
Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee.
Hematology and Stem Cell Transplantation Section, Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Veterans Affairs Medical Center, Nashville, Tennessee.
Biol Blood Marrow Transplant. 2014 Jul;20(7):908-19. doi: 10.1016/j.bbmt.2014.02.013. Epub 2014 Feb 22.
Hematopoietic stem cell transplantation (HSCT) is a potentially life-saving therapy that has traditionally been associated with high treatment-related mortality due to direct regimen toxicity and a high incidence of graft-versus-host disease. Historically, pre-existing renal insufficiency has been considered an exclusion criterion for transplantation. The advent of nonmyeloablative conditioning regimens as a less toxic modality for treatment has made HSCT more accessible to elderly patients and patients with comorbidities, such as renal impairment. However, there is no clear standard for how to dose preparative regimens for patients with chronic renal impairment who undergo HSCT. This article serves as a review of the current literature to provide dosing recommendations for commonly used preparative agents in the setting of chronic kidney disease, with the aim of providing optimal dosing for this patient population.
造血干细胞移植（HSCT）是一种可能挽救生命的治疗方法，传统上，由于直接的方案毒性和移植物抗宿主病的高发生率，它与较高的治疗相关死亡率相关。从历史上看，预先存在的肾功能不全一直被视为移植的排除标准。非清髓性预处理方案作为一种毒性较小的治疗方式的出现，使老年患者和患有合并症（如肾功能损害）的患者更容易接受HSCT。然而，对于接受HSCT的慢性肾功能损害患者，如何确定预处理方案的剂量尚无明确标准。本文对当前文献进行综述，以提供慢性肾脏病背景下常用预处理药物的剂量建议，旨在为该患者群体提供最佳剂量。
