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Therapeutic pathways of allogeneic and autologous hematopoietic stem cell transplantation recipients: a hospital pharmacist’s perspective
dc.contributor.author | Malnoë, David | |
dc.contributor.author | Lamande, Timothé | |
dc.contributor.author | Jouvance-Le Bail, Alexia | |
dc.contributor.author | Marchand, Tony | |
dc.contributor.author | Le Corre, Pascal | |
dc.date.accessioned | 2024-06-25T08:01:21Z | |
dc.date.available | 2024-06-25T08:01:21Z | |
dc.date.issued | 2024-06-20 | |
dc.identifier.citation | Malnoë, D.; et al. Therapeutic pathways of allogeneic and autologous hematopoietic stem cell transplantation recipients: a hospital pharmacist’s perspective. Ars Pharm, 65(3): 240-257 (2024). [10.30827/ars.v65i3.340246] | es_ES |
dc.identifier.issn | 2340-9894 | |
dc.identifier.uri | https://hdl.handle.net/10481/92807 | |
dc.description.abstract | Introduction: Patients undergoing allogeneic and autologous hematopoietic stem cell transplantation (Allo-HSCT and Auto-HSCT) are at risk of pharmacotherapy-related problems. Objective: To describe in Allo-HSCT and Auto-HSCT patients from admission to hospital discharge, their therapeutic profile, and the time-course of biomarkers of renal and liver dysfunction, and of inflammation to display a more specific overview of drug therapy in HSCT patients. Method: Data were retrospectively extracted from the charts of 20 Allo-HSCT and 20 Auto-HSCT patients. The therapeutic pathway was described by the turn-over of drug treatments, the potentially inappropriate medications by using the GO-PIM scale, and the anticholinergic burden. Patho-physiological variations affecting clearance organs were characterized by the C-Reactive Protein (CRP) levels, and the hepatic and renal impairment evaluation tools (Model for End-stage Liver Disease score: MELD score, and glomerular filtration rate: GFR). Results: Compared to Auto-HSCT patients, Allo-HSCT patients had a higher number of drugs initiated during hospital stay leading to hyper-polypharmacy during the stay and at discharge. Around 35 % of drugs used were metabolized by CYP3A4 in HSCT patients. Anticholinergic burden increased at discharge in HSCT patients. Auto-HSCT patients ≥ 65 years were taking at least one PIM. High CRP levels were reported in HSCT recipients. MELD score increased and GFR decreased in Allo-HSCT patients while GFR slightly increased in Auto-HSCT patients. Conclusion: Clinical pharmacist should target polypharmacy, PIM and anticholinergic burden, and evaluate inflammation and both renal and hepatic functions in order to thoughtfully assess the clearance potential of patients and to suggest individualized dosing. | es_ES |
dc.description.abstract | Introducción: Pacientes de trasplante de células madre hematopoyéticas autólogo y alogénico (Alo-TCMH y Auto-TCMH) enfrentan riesgos farmacoterapéuticos. Objetivo: Detallar el perfil terapéutico y la evolución de biomarcadores de disfunción renal, hepática e inflamatoria en pacientes de Alo- y Auto-TCMH desde su ingreso hasta el alta hospitalaria, ofreciendo una perspectiva detallada del manejo farmacológico. Método: Se extrajeron datos retrospectivos de las historias clínicas de 20 pacientes de Alo-TCMH y 20 de Auto-TCMH. Se describió el trayecto terapéutico mediante el cambio de tratamientos farmacológicos, los medicamentos potencialmente inapropiados utilizando la escala GO-PIM, y la carga anticolinérgica (CA). Se evaluaron las variaciones fisiopatológicas afectando órganos de eliminación, mediante niveles de proteína C reactiva (PCR), puntuación para la enfermedad hepática en etapa terminal (puntuación MELD) y filtración glomerular (FG). Resultados: Alo-TCMH pacientes tuvieron un mayor número de fármacos iniciados durante la estancia hospitalaria, lo que llevó a una hiperpolifarmacia durante la estancia y al alta. Un 35% de los medicamentos usados eran metabolizados por CYP3A4. CA aumentó al alta en pacientes de HSCT. Los pacientes de Auto-TCMH ≥ 65 años tomaban al menos un PIM. Se informaron niveles altos de CRP en los receptores de TCMH. Puntuación MELD aumentó y la GFR disminuyó en pacientes de Alo-TCMH mientras que la FG aumentó ligeramente en pacientes de Auto-TCMH. Conclusión: El farmacéutico clínico debe enfocarse en la polifarmacia, PIM y CA, y evaluar la inflamación y las funciones renales y hepáticas para evaluar de manera reflexiva el potencial de depuración de los pacientes y sugerir dosificaciones individualizadas. | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Universidad de Granada, Facultad de Farmacia. | es_ES |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | hematopoietic stem cell transplantation | es_ES |
dc.subject | C-reactive protein | es_ES |
dc.subject | Hepatic Insufficiency | es_ES |
dc.subject | list of potentially inappropriate medications | es_ES |
dc.subject | Trasplante de células madre hematopoyéticas; | es_ES |
dc.subject | Proteína C reactiva | es_ES |
dc.subject | Insuficiencia hepática | es_ES |
dc.subject | Lista de medicamentos potencialmente inapropiados | es_ES |
dc.title | Therapeutic pathways of allogeneic and autologous hematopoietic stem cell transplantation recipients: a hospital pharmacist’s perspective | es_ES |
dc.title.alternative | Trayecto terapéutico de receptores de trasplante de células madre hematopoyéticas: una perspectiva de farmacéuticos hospitalarios | es_ES |
dc.type | journal article | es_ES |
dc.rights.accessRights | open access | es_ES |
dc.identifier.doi | 10.30827/ars.v65i3.340246 | |
dc.type.hasVersion | VoR | es_ES |