Prophylactic trimethoprim-sulfamethoxazole is safe in adult patients with primary central nervous system lymphoma receiving high-dose methotrexate.

IF 3 3区医学 Q2 HEMATOLOGY Annals of Hematology Pub Date : 2024-12-18 DOI:10.1007/s00277-024-06146-4

Qinxia Xu, Ziran Li, Tianling Ding, Xiaoyan Qiu, Zhuo Wu

{"title":"Prophylactic trimethoprim-sulfamethoxazole is safe in adult patients with primary central nervous system lymphoma receiving high-dose methotrexate.","authors":"Qinxia Xu, Ziran Li, Tianling Ding, Xiaoyan Qiu, Zhuo Wu","doi":"10.1007/s00277-024-06146-4","DOIUrl":null,"url":null,"abstract":"This retrospective study investigated the potential drug-drug interactions between trimethoprim-sulfamethoxazole (TMP-SMZ) and high-dose methotrexate (HD-MTX) in adult patients with primary central nervous system lymphoma (PCNSL). A total of 143 Chinese adult patients with PCNSL who received 498 cycles of MTX were included. Differences in the pharmacokinetics of MTX, including Cmax, clearance (CL) and AUC0-48 h with and without co-administration of TMP-SMZ were assessed. The incidence of MTX-related acute kidney injury (AKI), hepatotoxicity, myelosuppression, and delayed MTX elimination at 48 and 72 h were also compared. Patients were divided into two cohorts for analysis: 146 cycles with TMP-SMZ exposure and 352 cycles without TMP-SMZ exposure. Patients who received TMP-SMZ concurrently with HD-MTX exhibited a 1.13-fold increase in Cmax, a 1.12-fold increase in AUC0-48 h and a reduction in CL by 0.87-fold for MTX. There was no significant difference in the incidence of MTX-related AKI, hepatotoxicity, myelosuppression, or delayed MTX elimination between the two cohorts. Prophylactic TMP-SMZ might lead to increased MTX exposure but has no impact on the incidence of myelosuppression, AKI, and hepatotoxicity. These results suggested that prophylactic TMP-SMZ is safe for adult patients with PCNSL receiving HD-MTX.","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Hematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00277-024-06146-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

This retrospective study investigated the potential drug-drug interactions between trimethoprim-sulfamethoxazole (TMP-SMZ) and high-dose methotrexate (HD-MTX) in adult patients with primary central nervous system lymphoma (PCNSL). A total of 143 Chinese adult patients with PCNSL who received 498 cycles of MTX were included. Differences in the pharmacokinetics of MTX, including C_max, clearance (CL) and AUC_0-48 h with and without co-administration of TMP-SMZ were assessed. The incidence of MTX-related acute kidney injury (AKI), hepatotoxicity, myelosuppression, and delayed MTX elimination at 48 and 72 h were also compared. Patients were divided into two cohorts for analysis: 146 cycles with TMP-SMZ exposure and 352 cycles without TMP-SMZ exposure. Patients who received TMP-SMZ concurrently with HD-MTX exhibited a 1.13-fold increase in C_max, a 1.12-fold increase in AUC_0-48 h and a reduction in CL by 0.87-fold for MTX. There was no significant difference in the incidence of MTX-related AKI, hepatotoxicity, myelosuppression, or delayed MTX elimination between the two cohorts. Prophylactic TMP-SMZ might lead to increased MTX exposure but has no impact on the incidence of myelosuppression, AKI, and hepatotoxicity. These results suggested that prophylactic TMP-SMZ is safe for adult patients with PCNSL receiving HD-MTX.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

预防性甲氧苄啶-磺胺甲恶唑对接受大剂量甲氨蝶呤治疗的原发性中枢神经系统淋巴瘤成年患者是安全的。

本回顾性研究探讨了甲氧苄啶-磺胺甲恶唑（TMP-SMZ）和大剂量甲氨蝶呤（HD-MTX）在成人原发性中枢神经系统淋巴瘤（PCNSL）患者中潜在的药物-药物相互作用。共纳入143例接受498个周期MTX治疗的中国成年PCNSL患者。评估MTX药代动力学的差异，包括Cmax、清除率（CL）和AUC0-48 h，与不联合给药TMP-SMZ。还比较了MTX相关急性肾损伤（AKI）、肝毒性、骨髓抑制和MTX在48和72 h的延迟消除的发生率。患者被分为两组进行分析：146个周期暴露于TMP-SMZ， 352个周期未暴露于TMP-SMZ。同时接受tp - smz和HD-MTX治疗的患者Cmax增加1.13倍，AUC0-48 h增加1.12倍，MTX治疗的CL减少0.87倍。在两个队列中，甲氨蝶呤相关AKI、肝毒性、骨髓抑制或甲氨蝶呤延迟消除的发生率没有显著差异。预防性TMP-SMZ可能导致MTX暴露增加，但对骨髓抑制、AKI和肝毒性的发生率没有影响。这些结果表明，预防性TMP-SMZ对于接受HD-MTX治疗的成年PCNSL患者是安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Annals of Hematology 医学-血液学

CiteScore

5.60

自引率

2.90%

发文量

304

审稿时长

2 months

期刊介绍： Annals of Hematology covers the whole spectrum of clinical and experimental hematology, hemostaseology, blood transfusion, and related aspects of medical oncology, including diagnosis and treatment of leukemias, lymphatic neoplasias and solid tumors, and transplantation of hematopoietic stem cells. Coverage includes general aspects of oncology, molecular biology and immunology as pertinent to problems of human blood disease. The journal is associated with the German Society for Hematology and Medical Oncology, and the Austrian Society for Hematology and Oncology.