Pharmacy Department, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain.
Pharmacy Department, Consorci Sanitari de Terrassa, Catalonia, Spain.
Int J Clin Pharm. 2020 Apr;42(2):351-354. doi: 10.1007/s11096-020-00977-7. Epub 2020 Feb 6.
Background Antiseizure prophylaxis is recommended when high-dose of busulfan is given as part of the conditioning regimens in the allogenic hematopoietic stem cell transplant. Phenytoin has been widely used but its pharmacokinetics and pharmacodynamics profile makes its use complicated. Levetiracetam is a safe, effective and well tolerated antiseizure drug with good results in epileptic patients. Objective To describe our experience using oral (p.o) levetiracetam 1000 mg every 12 h (q12h) as an antiseizure prophylaxis, evaluating its preventive effects and adverse event rates after a high-dose of intravenous (i.v.) busulfan, as part of the conditioning regimen Methods Retrospective study of patients who underwent an allogenic hematopoietic stem cell transplant with a conditioning regimen based on high-dose of busulfan between January and November 2017. Results The study population comprised 36 patients, of whom 18 (50%) had acute myeloid leukemia as diagnosis. No seizures occurred in any patient. Levetiracetam was well tolerated and no serious adverse events were reported. Conclusions Our results suggest that giving levetiracetam at 1000 mg q12h p.o starting 12 h before the administration of i.v. busulfan until 48 h after the last dose, can be used as an alternative in the prevention of busulfan-induced seizures in adults.
当大剂量白消安作为同种异体造血干细胞移植中的预处理方案的一部分时，建议进行抗癫痫预防。苯妥英已被广泛应用，但由于其药代动力学和药效学特征，其使用较为复杂。左乙拉西坦是一种安全、有效且耐受性良好的抗癫痫药物，在癫痫患者中取得了良好的效果。目的：描述我们使用口服（p.o）左乙拉西坦 1000mg 每 12 小时（q12h）作为抗癫痫预防的经验，评估其在高剂量静脉（i.v.）白消安后作为预处理方案的一部分的预防效果和不良事件发生率。方法：对 2017 年 1 月至 11 月期间接受高剂量白消安预处理方案的同种异体造血干细胞移植患者进行回顾性研究。结果：研究人群包括 36 例患者，其中 18 例（50%）为急性髓系白血病诊断。没有患者发生癫痫。左乙拉西坦耐受性良好，未报告严重不良事件。结论：我们的结果表明，在给予静脉白消安前 12 小时开始口服左乙拉西坦 1000mg q12h，直至最后一次剂量后 48 小时，可以作为成人预防白消安引起的癫痫发作的替代药物。
