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霉酚酸酯增加异基因造血干细胞移植受者腹泻的风险。

Mycophenolate mofetil increases the risk of diarrhea in allogeneic hematopoietic stem cell transplantation recipients.

机构信息

Pharmacy Department, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.

Hematological Department, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.

出版信息

J Int Med Res. 2023 Oct;51(10):3000605231206968. doi: 10.1177/03000605231206968.

Abstract

OBJECTIVES

Mycophenolate mofetil (MMF) was reported to be a main cause of diarrhea following organ transplantation. However, research on MMF-induced diarrhea following allogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently insufficient. This retrospective study examined the incidence of MMF-induced diarrhea among allo-HSCT recipients.

METHODS

Recipients were divided according to the receipt of MMF and the appearance of diarrhea. The differences in clinical information, MMF usage and trough concentrations, and the occurrence of diarrhea from the first day of conditioning treatment to 100 days after transplantation were analyzed.

RESULTS

In total, 32.9% of the recipients reported diarrhea. The incidence rate of diarrhea was higher in the MMF group than in the non-MMF group (40.0% vs. 16.7%). MMF-induced diarrhea usually occurred within 9 days of MMF initiation and persisted for 7.27 ± 3.54 days. The average body weight, MMF daily dose, and MMF trough concentration were higher in patients with diarrhea.

CONCLUSION

MMF increased the risk of diarrhea in allo-HSCT recipients, and the risk was related to the MMF dose and trough concentration. The difference in onset time could be a basis for identifying the cause of diarrhea in allo-HSCT recipients.

摘要

目的

霉酚酸酯(MMF)被报道是器官移植后腹泻的主要原因。然而,目前对于异基因造血干细胞移植(allo-HSCT)后 MMF 诱导性腹泻的研究还不够充分。本回顾性研究旨在调查 allo-HSCT 受者中 MMF 诱导性腹泻的发生率。

方法

根据是否使用 MMF 和是否出现腹泻对受者进行分组。分析从预处理治疗开始到移植后 100 天内的临床信息、MMF 使用和谷浓度差异以及腹泻的发生情况。

结果

共有 32.9%的受者报告出现腹泻。MMF 组腹泻的发生率高于非 MMF 组(40.0% vs. 16.7%)。MMF 诱导性腹泻通常在 MMF 开始后 9 天内发生,持续 7.27±3.54 天。腹泻患者的平均体重、MMF 日剂量和 MMF 谷浓度更高。

结论

MMF 增加了 allo-HSCT 受者发生腹泻的风险,且风险与 MMF 剂量和谷浓度有关。发病时间的差异可能是识别 allo-HSCT 受者腹泻病因的依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd4/10601400/c90ad459fbd9/10.1177_03000605231206968-fig1.jpg

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