Journal of Oncology Pharmacy Practice最新文献

{"title":"Evaluating the relationship between letermovir prophylaxis and medication regimen complexity Index over time in allogeneic hematopoietic stem cell transplant patients.","authors":"Anthony Quach, Nimish Patel, Hailey Hirata, Annie Bui, Julie Trinh, Shreya Bahl, Ila M Saunders","doi":"10.1177/10781552251330276","DOIUrl":"https://doi.org/10.1177/10781552251330276","url":null,"abstract":"<p><p>BackgroundThe medication regimen complexity index (MRCI) quantifies patient-level regimen complexity, and higher scores are associated with adverse clinical outcomes. Characterization of regimens using the MRCI for allogeneic hematopoietic cell transplant (allo-HCT) recipients remains unexplored. Regimens may include letermovir which is used for cytomegalovirus prophylaxis and may prevent the need for addition of complex preemptive therapies. However, quantification of complexity in patients receiving letermovir has not been described.ObjectiveThis study aimed to compare MRCI scores over a one-year period in allo-HCT recipients who received letermovir prophylaxis versus those who did not.MethodsA retrospective analysis included adults who underwent allo-HCT from January 1, 2016 to October 31, 2021. MRCI scores were calculated at admission, discharge, day +100, 6 months, and 1-year post-transplant.ResultsA total of 218 patients were included, with 67 receiving letermovir and 151 not receiving letermovir. Median MRCI scores were comparable at discharge post allo-HCT (23 [10-39] vs 22 [12-37], <i>p </i>= 0.97). However, at day +100, patients in the letermovir group exhibited significantly higher median scores compared to the non-letermovir group (59 [46-74] vs 50 [37-67], <i>p </i>= 0.009). By 1-year post allo-HCT, no significant difference in scores was observed between groups (47 [30-68] vs 41 [27-61], <i>p </i>= 0.12).Conclusion and RelevanceThis study revealed increased MRCI scores up to one year after transplantation in allo-HCT recipients receiving letermovir. The nonrandomized study design and potential patient differences between groups complicate the interpretation of the findings. Future analyses should aim to account for these differences.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251330276"},"PeriodicalIF":1.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of drug interactions in oncology: Prevalence, risk factors and severity in a tertiary care hospital.","authors":"Shreya Kolte, Srinivasa Chelluri, Priti Dhande","doi":"10.1177/10781552251338769","DOIUrl":"https://doi.org/10.1177/10781552251338769","url":null,"abstract":"<p><p>BackgroundPatients ongoing cytotoxic chemotherapy concomitantly receive drugs for prevention of adverse effects as well as treatment for comorbidity. Exposure to such large number of drugs increases the chances of drug-drug interactions. This study was planned to determine the potential drug interactions and risk factors associated with them, in cancer patients of a tertiary care teaching hospital.MethodologyProspective, observational study conducted in the adult and pediatric oncology units. Data of medications received by each patient entered in UpToDate software to get the information about potential drug interactions (pDDI). Any observed outcome due to the drug interaction was noted down along with its management. Welch's independent samples t-test was conducted to identify quantitative factors that had a significant impact on observed Drug-Drug Interactions (oDDI). Pearson's correlation coefficient was calculated for all quantitative variables.ResultsOut of 110 patients, pDDI were found in 93.6% of them and actually occurred in 49.1% of these patients. Most of the pDDI were between the co-administered drugs (67.1%) in whom supportive medications were given or patient monitored. Significant association was found between the number of drug-drug interactions (DDIs) and age of the patient (p = 0.020), total number of drugs used (p < 0.001), number of drugs for comorbidities (p = 0.024), and number of co-administered medications (p < 0.001).ConclusionHigh prevalence of drug interactions among cancer patients indicates the need to develop protocols for monitoring and effective communication between healthcare providers for safe and effective care.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251338769"},"PeriodicalIF":1.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, effectiveness and pharmacokinetics of high-dose propylene glycol-free melphalan (EVOMELA) with a prolonged infusion as myeloablative conditioning in Chinese multiple myeloma patients undergoing autologous stem cell transplantation: A prospective phase iv study.","authors":"Fengrong Wang, Zhen Cai, Dehui Zou, Wenming Chen, Yongping Song, Chengcheng Fu, Jiong Hu, Ting Yang, Xinchuan Chen, Jinsong Yan, Kaiyan Liu","doi":"10.1177/10781552251336172","DOIUrl":"https://doi.org/10.1177/10781552251336172","url":null,"abstract":"<p><p>BackgroundMelphalan formulated with modified cyclodextrin (β-cyclodextrin sulfobutyl ether sodium [BSES]) is widely used before autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM) because of its favorable solubility and stability versus conventional melphalan, but the efficacy and safety data on Chinese patients with MM who subsequently underwent ASCT are still limited.MethodsIn this prospective, open-label, non-randomized, interventional study, a total of 67 MM patients who were eligible for ASCT were enrolled and assigned to receive 200 mg/m² of Melphalan in two divided doses of 100 mg/m² on Days -3 and -2 before ASCT on Day 0. We evaluated the efficacy, safety and pharmacokinetics (PK) of a prolonged infusion of high-dose BSES-melphalan as the conditioning treatment in the patients.ResultsOverall, 67 patients received melphalan with the median infusion time of 136 min. All patients achieved myeloablation with a median time of 5 days. Median time to neutrophil and platelet engraftments was 11 and 12 days after ASCT, respectively. Within the 65 evaluable patients, 18 patients (27.7%) achieved stringent complete response, 21 (32.3%) achieved complete response, 18 (27.7%) achieved very good partial response, and 3 (4.6%) achieved partial response. No treatment-related mortality (TRM) or adverse events leading to study withdrawal were identified. Prolonged infusion resulted in a lower C_max but comparable AUCs.ConclusionsHigh-dose BSES-melphalan as a conditioning medicine is effective and safe in Chinese patients with MM before ASCT. Prolonging infusion duration may improve the safety without compromising efficacy.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251336172"},"PeriodicalIF":1.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic sinusoidal congestion associated with inotuzumab therapy in patients with B-cell acute lymphoblastic leukemia, a proposal for a new clinical entity: Calicheamicin syndrome.","authors":"Derek Tai, Daniel Park, Priscilla Soria, Pranati Shah, Kendall Wick, So Young Son, Won Jin Jeon, Kum-Ja Lee, Mojtaba Akhtari","doi":"10.1177/10781552251332278","DOIUrl":"https://doi.org/10.1177/10781552251332278","url":null,"abstract":"<p><p>Inotuzumab (InO) is an anti-CD22 immunoconjugate for patients with relapsed or refractory CD22 positive B-cell acute lymphoblastic leukemia (B-ALL). Liver toxicity is a recognized side effect of InO, including sinusoidal obstruction syndrome (SOS), but is not fully understood. This study describes a new aspect of InO-induced hepatotoxicity by outlining six patients who developed abnormal liver function tests (LFTs) and thrombocytopenia, with liver biopsies showing sinusoidal congestion without evidence of SOS. Liver biopsies were obtained from all six patients and LFTs were monitored before initiating InO treatment, during treatment, and after discontinuing treatment. All six patients experienced abnormal LFTs at a median of 15 days after the last dose of InO and improvement in LFTs at a median of 17 days after discontinuing InO. Initial baseline AST, ALT, ALP, and total bilirubin values prior to InO therapy ranged from 10-45 U/L, 10-45 U/L, 60-207 U/L, and 0.2-0.9 mg/dL respectively and increased up to 2 to 4 times the upper limit of normal after completing varying cycles of InO with hepatotoxicity grades ranging from 1-2. LFTs returned to 1 to 1.5 times the upper limit of normal after discontinuing InO. The patients' liver biopsies all demonstrated different levels of hepatic sinusoidal congestion (HSC) without evidence of SOS. This study provides new evidence describing HSC, where we hypothesize that InO induced hepatotoxicity are due to calicheamicin. We propose a new clinical entity called \"calicheamicin syndrome\" with its quadriad components: History of using InO or GO, elevated LFTs, thrombocytopenia, and abnormal liver imaging.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251332278"},"PeriodicalIF":1.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and tolerability of adjuvant combination treatments following KEYNOTE-522 for early-stage or locally advanced breast cancer with residual disease.","authors":"Julie Lyon Boucher, Katie Lynn Konieczny, Blerina Mukallari, Eva Yifang Pan, Annette Hood, Mara Hofherr","doi":"10.1177/10781552251333650","DOIUrl":"https://doi.org/10.1177/10781552251333650","url":null,"abstract":"<p><p>IntroductionPatients with residual invasive carcinoma after neoadjuvant chemotherapy (NACT) for early-stage breast cancer have poor prognoses. The primary objective of this study was to assess the safety and tolerability of adjuvant combination regimens in patients with residual disease after KEYNOTE-522 NACT and surgery.MethodsPatients ≥ 18 years old with triple-negative or hormone-receptor low positive early-stage breast cancer were included if treated with KEYNOTE-522 NACT (modified to dose-dense doxorubicin plus cyclophosphamide (ddAC) in most patients). After definitive surgery, patients were assessed for residual disease and whether they received adjuvant capecitabine or a poly ADP ribose polymerase (PARP) inhibitor concurrently with pembrolizumab or sequentially after pembrolizumab. Adverse effects and dose modifications were collected.ResultsTwenty-two patients received concurrent treatment and eight received sequential treatment. Higher rates of toxicity occurred when two adjuvant agents were administered concurrently compared to sequentially (p-value = 0.166). The concurrent group also had more capecitabine dose adjustments (50% vs. 37.5%), doses held (36.4% vs. 25%) and discontinuations (9.1% vs. 0%) as well as pembrolizumab discontinuations (13.67% vs. 0%). The pathologic complete response (pCR) rates were higher with the use of ddAC than with every-3-weeks doxorubicin plus cyclophosphamide (AC) administered in KEYNOTE-522 (84.7% vs. 64.8%).ConclusionConcurrent therapy with pembrolizumab and capecitabine or olaparib trended towards demonstrating more toxicities than sequential therapy, though not statistically significant. However, concurrent therapy can be completed with dose adjustments or holds per patient tolerability. Additionally, our findings suggest modifying NACT KEYNOTE-522 to ddAC may improve response rates over traditional NACT KEYNOTE-522.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251333650"},"PeriodicalIF":1.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of medicinal plants by cancer patients receiving chemotherapy: A cross-sectional study at a referral oncology hospital in Morocco.","authors":"Aichetou Bouh, Slimane Mehdad, Nouriya El Ghoulam, Daoud Daoudi, Ahmed Oubaasri, Fatima Zahra El Mskini, Asmae Labyad, Hinde Iraqi, Souad Benaich, Rachida Hassikou, Hassan Errihani, Saber Boutayeb","doi":"10.1177/10781552251331920","DOIUrl":"https://doi.org/10.1177/10781552251331920","url":null,"abstract":"<p><p>Background and aimThe high cost of cancer treatment and adverse side effects of drug therapy remain major health issues worldwide. Medicinal plants (MP) can be used to promote new, safe, and effective anticancer medications. This study aimed to estimate the prevalence of MP use among cancer patients, investigate its association with sociodemographic and clinical factors, and provide available information about the species used.Materials and methodsThis was a cross-sectional study among 508 patients undergoing chemotherapy. Sociodemographic data and information on MPs used in cancer treatment were collected using face-to-face interviews and a questionnaire. Clinical data were obtained from the hospital database. Ethnobotanical indices, including relative citation frequency, informed consensus factor, and fidelity level, were determined for data analysis.Results43.2% of patients used MPs. Of these, 66.3% did not disclose information about MPs to their physicians, 54% experienced improvements, and 6% reported undesirable side effects associated with using MPs. There was a significant association of MPs use with disease duration (<i>P </i>= 0.037) and cancer type (<i>P </i>< 0.001). 27 plant species belonging to 17 families were identified, with Lamiaceae, Apiaceae, and Fabaceae being the most common. The most used species were <i>Origanum compactum benth</i>., <i>Marrubium vulgare</i> L., <i>Trigonella foenum-graecum</i> L., <i>Aloysia citriodora</i>, and <i>Rosmarinus officinalis</i> L.ConclusionThis study showed a high prevalence of MPs use among patients undergoing chemotherapy. Although further studies are needed to investigate the efficacy and safety of commonly used species, our findings may be used to inform evidence-based guidelines, promote communication between cancer patients and healthcare providers, and develop new medicinal plants.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251331920"},"PeriodicalIF":1.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of bevacizumab preparation conditions on inline-filter blockage.","authors":"Chiaki Ogawa, Megumi Yatabe, Yoshiyuki Nagayama, Kazuhiko Nakadate, Shigeru Adachi, Motoki Inoue","doi":"10.1177/10781552251336176","DOIUrl":"https://doi.org/10.1177/10781552251336176","url":null,"abstract":"<p><p>PurposeThis study aimed to investigate the effects of preparation conditions and external factors, particularly ultraviolet (UV) exposure, on inline-filter clogging in liquid monoclonal antibody (l-mAb) formulations. Bevacizumab (BmAb) was used as a model drug to address the critical question of how UV exposure impacts protein stability and filter performance during clinical administration.MethodsBevacizumab solutions were exposed to UV-C (254 nm) light to evaluate its effects on protein stability and filter clogging. Scanning electron microscopy (SEM) was used to visualize protein aggregates on the filter surface. Dynamic light scattering (DLS) analysis measured particle size distribution and average particle size. To assess the effectiveness of light shielding, additional samples were prepared under conditions that minimized UV exposure.ResultsUV-C exposure induced significant precipitate formation, with SEM images revealing protein aggregates on the filter surface. DLS analysis showed a broader particle size distribution and an increase in average particle size (18.1 nm) in UV-exposed solutions compared to non-exposed controls. Light shielding effectively suppresses precipitate formation, maintaining the stability of BmAb solutions and preventing inline-filter clogging.ConclusionUV-C destabilizes BmAb solutions, leading to protein aggregation and inline-filter clogging. Light shielding was identified as an effective strategy to maintain the stability and safety of l-mAb formulations, particularly in settings where prolonged exposure to environmental light is possible. These findings emphasize the importance of implementing protective measures against UV exposure and call for further research on additional environmental factors and optimized protocols to enhance l-mAb formulation reliability.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251336176"},"PeriodicalIF":1.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global oncology pharmacy service levels and knowledge requirements: A review by the International Society of Oncology Pharmacy Practitioners.","authors":"Marissa Ryan, Evelyn Handel Zapata, Irene Weru, Annette Netty V Cracknell","doi":"10.1177/10781552251332199","DOIUrl":"https://doi.org/10.1177/10781552251332199","url":null,"abstract":"<p><p>IntroductionThe International Society of Oncology Pharmacy Practitioners (ISOPP) has over 3500 members across 110 countries. ISOPP's strategic objectives are membership engagement, empowering the global oncology pharmacy community, facilitating professional development, and advocating for advancement. Aligning with these objectives, this research aimed to describe global oncology pharmacy service provision and knowledge requirements.MethodsFifty-three ISOPP global oncology pharmacy leaders from 45 countries were invited to complete a survey. Questions in the survey explored whether protected titles existed for oncology practitioners, the oncology pharmacy service levels that were being offered from the seven levels proposed, knowledge requirements for these levels, and access to education. Free text comments were analyzed for context or themes and described descriptively. Based on responses, the proposed service levels and required knowledge were reviewed to establish the ISOPP Oncology Pharmacy Service Levels.ResultsResponses from 35 countries were received. Thirty-five (100%) participants reported that pharmacist was a protected title, and 18 (51%) participants reported that pharmacy technician was protected. However, oncology pharmacist was a protected title in one (3%) country only, Singapore. Fourteen (40%) countries delivered all seven levels, and 35 (100%) countries delivered at least three levels. Some participants reported being unfamiliar with some of the survey terminology; this information was used to clarify the wording of the service levels and knowledge requirements.ConclusionThis global review of oncology pharmacy services will aid professional development and advancement, by connecting countries with mentoring opportunities and resources, and establishing a benchmark for the future growth of services globally.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251332199"},"PeriodicalIF":1.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist tailored monitoring for patients initiating encorafenib and binimetinib combination therapy.","authors":"Brooke D Looney, Stephanie G White, Josh DeClercq, Autumn D Zuckerman, Leena Choi, Nisha B Shah, Kristen W Whelchel","doi":"10.1177/10781552251334995","DOIUrl":"https://doi.org/10.1177/10781552251334995","url":null,"abstract":"<p><p><b>Introduction:</b> Combination therapy with protein kinase B-raf (BRAF) inhibitor, encorafenib, and mitogen-activated extracellular kinase (MEK) inhibitor, binimetinib, is associated with adverse events (AEs) that can lead to therapy changes early in treatment. This study assessed the impact of pharmacist tailored monitoring on therapy changes during the first 90 days after initiation. <b>Methods:</b> This single center, pre-post intervention study included adult patients initiating encorafenib and binimetinib for unresectable or metastatic melanoma, with prescriptions filled through the center's specialty pharmacy or manufacturer's assistance program from July 2018 to December 2019 and April 2021 to December 2022. Beginning April 2021, a tailored monitoring program was implemented. Patients received counseling and a welcome kit at therapy initiation, followed by 6 monitoring calls over the first 90 days aligned with expected AE onset. <b>Results:</b> The number of patients in the pre-intervention (<i>n</i> = 18) and post-intervention (<i>n</i> = 19) cohorts was similar. Fewer patients in the pre-intervention cohort had treatment interruptions (pre 44%, post 58%), dose reductions (pre 39%, post 47%), and discontinuations (pre 11%, post 26%) compared to the post-intervention arm. Most patients reported at least 1 AE within 14 days of initiating therapy (pre 78%, post 95%). The most reported AEs pre- and post-intervention were fatigue (pre 56%, post 68%), nausea (pre 44%, post 74%), and diarrhea (pre 17%, post 47%). Post-intervention, all patients (<i>n</i> = 19) received pharmacist interventions, with patient education (95%) and supportive therapy (68%) being the most frequent. <b>Conclusions:</b> This study supports the HOPA recommendation to follow-up with patients 7-14 days after oral anticancer medication initiation. More studies are needed to evaluate the benefit of increased pharmacist monitoring after the first 2 weeks of therapy.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251334995"},"PeriodicalIF":1.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effect of closed system transfer device syringe adaptor connection in the isolator on cytotoxic residue contamination during intravenous administration.","authors":"Louisa Knowles","doi":"10.1177/10781552251334027","DOIUrl":"https://doi.org/10.1177/10781552251334027","url":null,"abstract":"<p><p>IntroductionThe European Biosafety Network recommends that cytotoxic drug surface contamination in pharmacies and patient wards not exceed 0.1 ng/cm². Among other mitigations, closed system transfer devices (CSTDs) are recommended in the US, Europe, and UK for the reduction of surface contamination. Although in the UK CSTDs are not part of standard cytotoxic preparation procedures in isolators, CSTD syringe adaptors are recommended for use with syringes for intravenous administration. We investigated whether the addition of a CSTD syringe adaptor in the isolator reduces cytotoxic residue contamination during intravenous bolus administration.MethodsTwenty-five cyclophosphamide syringes were prepared with hub caps and twenty-five with SIMPLIVIA^® (formerly Tevadaptor/OnGuard^®) Syringe Adaptor Locks (SALs) in an isolator. Surface contamination of syringes, gauze pads placed at the administration site, and nurses' gloves was compared between the practice of connecting hub caps in the isolator and removing them in the ward versus connecting SALs in the isolator during preparation. Cyclophosphamide contamination was quantified by liquid-chromatography mass spectrometry.ResultsUse of SALs compared to standard hub caps led to statistically significant reduction in cyclophosphamide contamination on the syringes (2.41 ± 0.89 ng versus 33.42 ± 8.48 ng, p = 0.0007), the swabs used for connect/disconnect (0.01372 ± 0.01 ng versus 655.80 ± 190.18 ng, p = 0.001), and nurses' gloves (0.0009 ± 0.0009 ng versus 8.31 ± 3.94 ng, p = 0.04). When hub caps were used, 48% of syringes, 76% of gauze pads, and 8% of gloves exceeded the recommended limit of 0.1 ng/cm², while no samples exceeded this limit with SAL.ConclusionsThe implementation of CSTD syringe adaptors was beneficial for reducing cytotoxic drug exposure to nurses administering intravenous syringes.</p>","PeriodicalId":16637,"journal":{"name":"Journal of Oncology Pharmacy Practice","volume":" ","pages":"10781552251334027"},"PeriodicalIF":1.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}