Education and Research Center for Clinical Pharmacy, Osaka Medical and Pharmaceutical University, Osaka, Japan;
Department of Education and Research Center for Pharmacy Practice, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kyoto, Japan.
In Vivo. 2022 May-Jun;36(3):1461-1467. doi: 10.21873/invivo.12852.
BACKGROUND/AIM: High-dose chemotherapy is frequently administered to patients with hematologic malignancies, thereby causing severe adverse drug reactions (ADRs) at a relatively high frequency. To precisely monitor ADRs, we developed a medication instruction sheet (MIS) for patients who received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) combination therapy for non-Hodgkin's lymphoma (NHL). Herein, we evaluated the usefulness of the MIS for managing ADRs in patients who received R-CHOP therapy.
We included patients aged ≥20 years who received R-CHOP therapy as first-line treatment for NHL at the Department of Hematology, Kyushu University Hospital, between August 2014 and December 2018. Medical professionals evaluated the possible occurrence of ADRs according to the present MIS and ADRs were graded according to the Common Toxicity Criteria, version 4.0 (National Cancer Institute, Bethesda, MD, USA). Finally, the accuracy of the MIS in predicting the occurrence of ADRs of different grades and during definite periods was evaluated.
Seventy-five patients with NHL were included in the present study. Overall, 359 ADR events were monitored, which were predicted ADR items listed in the MIS. Among these, 254 (71%) events occurred during the same period as those listed in the MIS. The onset timing of any grade of an infusion reaction and peripheral neuropathy precisely matched those listed in the MIS. However, the accuracy of the MIS was reduced in patients with thrombocytopenia (42%).
The present MIS could be useful for monitoring ADRs in patients with cancer undergoing R-CHOP therapy.
背景/目的：高剂量化疗经常用于血液系统恶性肿瘤患者，因此会以相对较高的频率引起严重的药物不良反应（ADR）。为了准确监测 ADR，我们为接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松（R-CHOP）联合治疗非霍奇金淋巴瘤（NHL）的患者开发了用药指导单（MIS）。在此，我们评估了 MIS 用于管理接受 R-CHOP 治疗的患者 ADR 的有用性。
我们纳入了 2014 年 8 月至 2018 年 12 月在九州大学医院血液科接受 R-CHOP 作为 NHL 一线治疗的年龄≥20 岁的患者。医务人员根据目前的 MIS 评估 ADR 发生的可能性，并根据通用毒性标准 4.0（美国国立癌症研究所，贝塞斯达，MD）对 ADR 进行分级。最后，评估 MIS 在预测不同等级和特定时间段 ADR 发生的准确性。
本研究共纳入 75 例 NHL 患者。共监测到 359 次 ADR 事件，这些事件都是 MIS 中预测的 ADR 项目。其中，254 次（71%）事件发生在 MIS 中列出的同期。输注反应和周围神经病变的任何等级的发病时间都与 MIS 中列出的时间精确匹配。然而，血小板减少症患者（42%）的 MIS 准确性降低。
本 MIS 可用于监测接受 R-CHOP 治疗的癌症患者的 ADR。
