与5-氟胞嘧啶治疗相关的骨髓毒性。
Bone marrow toxicity associated with 5-fluorocytosine therapy.
作者信息
Kauffman C A, Frame P T
出版信息
Antimicrob Agents Chemother. 1977 Feb;11(2):244-7. doi: 10.1128/AAC.11.2.244.
Abstract
Bone marrow toxicity occurred in 4 of 15 patients treated with 5-fluorocytosine (5-FC) for serious fungal infections. The development of marrow toxicity appeared to be related to serum 5-FC levels of 125 mug/ml or greater. In three patients, accumulation of toxic levels of 5-FC was related to diminished renal function. One patient with acute renal failure and prolonged high levels of 5-FC developed marrow aplasia and died of bacterial sepsis. Three patients experienced leukopenia, which was readily reversed when the dosage of 5-FC was decreased and the serum concentration was lowered. With careful monitoring of serum 5-FC concentration and renal function, the dose-related toxic effects of 5-FC on the marrow can be avoided.
摘要
15名因严重真菌感染接受5-氟胞嘧啶（5-FC）治疗的患者中有4名出现了骨髓毒性。骨髓毒性的发生似乎与血清5-FC水平达到或高于125微克/毫升有关。在3名患者中，5-FC毒性水平的积累与肾功能减退有关。1名患有急性肾衰竭且5-FC水平长期居高不下的患者发生了骨髓再生障碍，并死于细菌性败血症。3名患者出现白细胞减少，当5-FC剂量减少且血清浓度降低时，白细胞减少情况迅速得到逆转。通过仔细监测血清5-FC浓度和肾功能，可以避免5-FC对骨髓的剂量相关毒性作用。
相似文献
1
Bone marrow toxicity associated with 5-fluorocytosine therapy.与5-氟胞嘧啶治疗相关的骨髓毒性。
Antimicrob Agents Chemother. 1977 Feb;11(2):244-7. doi: 10.1128/AAC.11.2.244.
2
Therapy of deep-seated fungal infections with 5-fluorocytosine.用5-氟胞嘧啶治疗深部真菌感染。
Aust N Z J Med. 1974 Oct;4(5):462-7. doi: 10.1111/j.1445-5994.1974.tb03218.x.
3
Cryptococcal meningitis. Fatal marrow aplasia from combined therapy.隐球菌性脑膜炎。联合治疗导致的致命性骨髓再生障碍。
JAMA. 1978 Mar 13;239(11):1068-9. doi: 10.1001/jama.239.11.1068.
4
[Marrow aplasia and 5-fluorocytosine].[骨髓再生障碍与5-氟胞嘧啶]
Nouv Presse Med. 1980 Jan 26;9(5):319.
5
Evidence for conversion of 5-fluorocytosine to 5-fluorouracil in humans: possible factor in 5-fluorocytosine clinical toxicity.人类体内5-氟胞嘧啶转化为5-氟尿嘧啶的证据：5-氟胞嘧啶临床毒性的可能因素。
Antimicrob Agents Chemother. 1978 Dec;14(6):903-8. doi: 10.1128/AAC.14.6.903.
6
[Treatment of mycoses in children with 5-fluorocytosine].[5-氟胞嘧啶治疗儿童真菌病]
Padiatr Grenzgeb. 1976;15(5):241-7.
7
Candida endocarditis treated with 5-fluorocytosine.用5-氟胞嘧啶治疗的念珠菌性心内膜炎。
Br Med J. 1971 Jan 30;1(5743):262-4. doi: 10.1136/bmj.1.5743.262.
8
[5-fluorocytosine--a new antimycotic drug].[5-氟胞嘧啶——一种新型抗真菌药物]
Lakartidningen. 1976 Jun 16;73(25):2342-4.
9
Combined treatment with amphotericin B and flucytosine in severe fungal infections.两性霉素B与氟胞嘧啶联合治疗严重真菌感染。
J Antimicrob Chemother. 1976 Sep;2(3):239-46. doi: 10.1093/jac/2.3.239.
10
Experimental endocarditis: prophylaxis of Candida albicans infections by 5-fluorocytosine in rabbits.实验性心内膜炎：5-氟胞嘧啶对兔白色念珠菌感染的预防作用
Antimicrob Agents Chemother. 1979 Sep;16(3):252-4. doi: 10.1128/AAC.16.3.252.
引用本文的文献
1
Enhancing Flucytosine Anticandidal Activity Using PEGylated Squalene Nanocarrier.使用聚乙二醇化角鲨烯纳米载体增强氟胞嘧啶的抗念珠菌活性。
ChemMedChem. 2025 Jan 2;20(1):e202400432. doi: 10.1002/cmdc.202400432. Epub 2024 Nov 20.
2
Innovations in Antifungal Drug Discovery among Cell Envelope Synthesis Enzymes through Structural Insights.通过结构洞察实现细胞包膜合成酶抗真菌药物发现的创新。
J Fungi (Basel). 2024 Feb 22;10(3):171. doi: 10.3390/jof10030171.
3
An update on the global treatment of invasive fungal infections.全球侵袭性真菌感染治疗的最新进展。
Future Microbiol. 2023 Nov;18(15):1095-1117. doi: 10.2217/fmb-2022-0269. Epub 2023 Sep 26.
4
Therapeutic Drug Monitoring of Antifungal Agents in Critically Ill Patients: Is There a Need for Dose Optimisation?重症患者抗真菌药物的治疗药物监测：是否需要优化剂量？
Antibiotics (Basel). 2022 May 12;11(5):645. doi: 10.3390/antibiotics11050645.
5
Molecular Mechanisms of 5-Fluorocytosine Resistance in Yeasts and Filamentous Fungi.酵母和丝状真菌中5-氟胞嘧啶耐药性的分子机制
J Fungi (Basel). 2021 Oct 27;7(11):909. doi: 10.3390/jof7110909.
6
Pharmacokinetics and tolerance of repeated oral administration of 5-fluorocytosine in healthy dogs.健康犬体内重复给予 5-氟胞嘧啶的药代动力学和耐受性。
BMC Vet Res. 2021 Jun 21;17(1):220. doi: 10.1186/s12917-021-02927-5.
7
Too Much of a Good Thing: Defining Antimicrobial Therapeutic Targets to Minimize Toxicity.过犹不及：确定抗菌治疗靶点以降低毒性。
Clin Pharmacol Ther. 2021 Apr;109(4):905-917. doi: 10.1002/cpt.2190. Epub 2021 Feb 27.
8
Antimicrobial therapeutic drug monitoring in critically ill adult patients: a Position Paper.危重症成人患者的抗菌治疗药物监测：立场文件。
Intensive Care Med. 2020 Jun;46(6):1127-1153. doi: 10.1007/s00134-020-06050-1. Epub 2020 May 7.
9
Nucleoside Analogues as Antibacterial Agents.作为抗菌剂的核苷类似物
Front Microbiol. 2019 May 22;10:952. doi: 10.3389/fmicb.2019.00952. eCollection 2019.
10
Efficacy of Prosopilosidine from var. against Infection in a Murine Model.白头翁素对 感染的疗效。
Molecules. 2018 Jul 10;23(7):1674. doi: 10.3390/molecules23071674.
本文引用的文献
1
The metabolism of 5-fluorocytosine-2-14-C and of cytosine-14-C in the rat and the disposition of 5-fluorocytosine-2-14-C in man.5-氟胞嘧啶-2-¹⁴C和胞嘧啶-¹⁴C在大鼠体内的代谢以及5-氟胞嘧啶-2-¹⁴C在人体内的分布。
Biochem Pharmacol. 1966 Apr;15(4):435-46. doi: 10.1016/0006-2952(66)90254-1.
2
Serologic tests in diagnosis and prognosis of cryptococcosis.血清学检测在隐球菌病诊断和预后中的应用
JAMA. 1966 Sep 19;197(12):961-7.
3
In vitro studies with 5-fluorocytosine.5-氟胞嘧啶的体外研究。
Appl Microbiol. 1969 Jun;17(6):871-7. doi: 10.1128/am.17.6.871-877.1969.
4
5-fluorocytosine and urinary candidiasis.5-氟胞嘧啶与尿念珠菌病
Br Med J. 1971 Mar 13;1(5749):577-9. doi: 10.1136/bmj.1.5749.577.
5
Severe candidiasis associated with thymic dysplasia, IgA deficiency, and plasma antilyMPHOCYTE EFFECTS.
Pediatrics. 1970 Jun;45(6):926-36.
6
Candida endocarditis treated with 5-fluorocytosine.用5-氟胞嘧啶治疗的念珠菌性心内膜炎。
Br Med J. 1971 Jan 30;1(5743):262-4. doi: 10.1136/bmj.1.5743.262.
7
Torulopsis glabrata renal infection.光滑念珠菌肾感染
Am J Med. 1974 Aug;57(2):217-24. doi: 10.1016/0002-9343(74)90446-x.
8
Flucytosine and amphotericin B: hemodialysis effects on the plasma concentration and clearance. Studies in man.氟胞嘧啶与两性霉素B：血液透析对血浆浓度及清除率的影响。人体研究。
Ann Intern Med. 1974 May;80(5):613-7. doi: 10.7326/0003-4819-80-5-613.
9
Pharmacokinetic studies on the oral antimycotic agent 5-fluorocytosine in individuals with normal and impaired kidney function.
Chemotherapy. 1973;18(6):321-36. doi: 10.1159/000221279.
10
The kinetics of 5-fluorocytosine elimination in man.
Aust N Z J Med. 1972 May;2(2):153-8. doi: 10.1111/j.1445-5994.1972.tb03925.x.
Zotero 插件