接受大剂量蒽环类药物治疗的儿童、青少年和青年肿瘤患者的血清肉碱浓度和心脏功能。

Q2 Medicine
Christine Lin, Hari K Narayan, Erin Trovillion, Saro Armenian, Lawrence Alejandro, Dennis John Kuo
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引用次数: 0

摘要

目的蒽环类化疗药物具有明显的剂量依赖性心脏毒性作用。-肉碱是一种非必需氨基酸,参与长链脂肪酸的氧化,缺乏肉碱可导致心肌病和心律失常。如果在化疗期间同时补充肉碱,则可作为预防心脏毒性的一种潜在策略。然而,在儿童、青少年和青年(CAYA)年龄段的癌症治疗过程中,血清肉碱浓度与蒽环类药物心脏毒性之间的关系尚未确定:这项前瞻性试点队列研究描述了新诊断的 CAYA 癌症患者在接受大剂量蒽环类药物治疗前、治疗期间和治疗后约 1 年血清肉碱浓度和心脏功能的变化:在平均累积蒽环类药物剂量为 409 毫克/平方米-多柔比星当量的 21 名患者中,左心室射血分数和相对室壁厚度下降,表明心脏功能整体下降。血清肉碱浓度也出现了可逆性下降。血清左旋肉碱浓度每下降 1 毫摩尔/升,左室射血分数就会下降 0.09%(p = 0.2):这项小型试验研究的结果表明,蒽环类药物治疗后,血清左旋肉碱浓度与心脏功能之间可能存在某种关系,应在更大规模的研究中进行评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Serum Carnitine Concentrations and Cardiac Function in Pediatric, Adolescent and Young Adult Oncology Patients Receiving High-Dose Anthracyclines.

Objective: Anthracycline chemotherapy agents have significant dose-dependent cardiotoxic effects. -Carnitine, a non-essential amino acid, is involved in long chain fatty acid oxidation, and carnitine deficiency can result in cardiomyopathy and cardiac arrhythmias. If administered concurrently with chemotherapy, carnitine supplementation could be a potential strategy to prevent cardiotoxicity. However, the association between serum carnitine concentrations and anthracycline cardiotoxicity during cancer treatment in the childhood, adolescent, and young adult (CAYA) age range has not been established.

Methods: This prospective pilot cohort study characterized changes in serum carnitine concentrations and cardiac function before, during, and approximately 1 year after large-dose anthracycline therapy in newly diagnosed CAYA cancer patients.

Results: Among 21 patients with a mean cumulative anthracycline dose exposure of 409 mg/m2 of -doxorubicin equivalents, left ventricular ejection fraction and relative wall thickness decreased, indicating an overall decline in cardiac function. A reversible decrease in serum carnitine concentrations was also observed. A non-statistically significant positive correlation was observed; for every 1 mmol/L decrease in serum carnitine concentration, there was a 0.09% decrease in LVEF (p = 0.2).

Conclusions: These findings from this small pilot study suggest that there may be a relationship between serum carnitine concentrations and cardiac function after anthracycline therapy that should be evaluated in larger studies.

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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
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