Chung Hyewon, Yu Kyung-Sang, Hong Kyung Taek, Choi Jung Yoon, Hong Che Ry, Kang Hyoung Jin, Park Kyung Duk, Shin Hee Young, Lee SeungHwan
*Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital; and †Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Ther Drug Monit. 2017 Jun;39(3):208-210. doi: 10.1097/FTD.0000000000000395.
Busulfan is a cytotoxic agent used in preconditioning for hematopoietic stem cell transplantation. Therapeutic drug monitoring of busulfan is necessary owing to its narrow therapeutic range. Patients undergoing preconditioning are susceptible to infection and might require coadministration of antibiotics. We present a case study of a 3-year-old girl with precursor T-cell acute lymphoblastic leukemia who received intravenous busulfan before hematopoietic stem cell transplantation. Metronidazole was coadministered before the third dose of busulfan because of Clostridium difficile infection. The daily pharmacokinetic analysis revealed that the clearance reduced to 57% of that before the coadministration. Although the underlying mechanism is unclear, a significant pharmacokinetic interaction was observed between busulfan and metronidazole, underscoring the importance of therapeutic drug monitoring.
白消安是一种细胞毒性药物，用于造血干细胞移植的预处理。由于其治疗窗狭窄，对白消安进行治疗药物监测很有必要。接受预处理的患者易感染，可能需要联合使用抗生素。我们报告了一例3岁前体T细胞急性淋巴细胞白血病女孩在造血干细胞移植前接受静脉注射白消安的病例研究。由于艰难梭菌感染，在第三剂白消安之前联合使用了甲硝唑。每日药代动力学分析显示，清除率降至联合用药前的57%。尽管潜在机制尚不清楚，但观察到白消安与甲硝唑之间存在显著的药代动力学相互作用，这突出了治疗药物监测的重要性。
