ความรู้ทั่วไปสำหรับเภสัชกรเกี่ยวกับการปลูกถ่ายเซลล์ต้นกำเนิดเม็ดเลือดในเด็ก
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ก.พ. 10, 2019
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เภสัชกร มะเร็งในเด็ก การปลูกถ่ายเซลล์ต้นกำเนิดเม็ดเลือด ยาเคมีบำบัดขนาดสูงก่อนปลูกถ่าย
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บทคัดย่อ
การปลูกถ่ายเซลล์ต้นกำเนิดเม็ดเลือด (hematopoietic stem cell transplantation: HSCT) มีจุดมุ่งหมายเพื่อทดแทนเซลล์ที่ผิดปกติในไขกระดูกหรือเพิ่มศักยภาพในการรักษาโรคร้ายชนิดต่าง ๆ ในเด็กให้มีโอกาสหายขาด เช่น โรคมะเร็งเม็ดเลือด มะเร็งชนิดก้อน โรคโลหิตจางธาลัสซีเมียระดับรุนแรง โรคไขกระดูกฝ่อชนิดรุนแรง และกลุ่มโรคทางภูมิคุ้มกันบกพร่องตั้งแต่กำเนิด ก่อนการทำ HSCT เซลล์ต้นกำเนิดดั้งเดิมในไขกระดูกของผู้ป่วยจำเป็นจะต้องถูกทำลายเสียก่อนโดยการให้ยาเคมีบำบัดขนาดสูง (อาจใช้ร่วมกับการฉายรังสี) ที่เรียกว่า preparative regimens โดยใช้เวลาประมาณ 5-10 วันแล้วแต่สูตรการรักษา เซลล์ต้นกำเนิดเม็ดเลือดที่ปลูกถ่ายให้แก่ผู้ป่วยมีแหล่งที่มาจาก 3 แหล่ง ได้แก่ ไขกระดูก กระแสเลือด หรือสายสะดือของผู้บริจาค จากนั้นจะนำมาบริหารให้แก่ผู้ป่วยหลังจากได้รับสูตรยา preparative regimens เสร็จสิ้นแล้ว กระบวนการปลูกถ่ายเซลล์ต้นกำเนิดอาจมีรายละเอียดแตกต่างกันในผู้ป่วยเด็กแต่ละราย ขึ้นอยู่กับชนิดและความรุนแรงของโรค สภาพความพร้อมทางร่างกาย ชนิดของการปลูกถ่าย แหล่งของเซลล์ต้นกำเนิด ชนิดของสูตรยา preparative regimens และยาที่ใช้ในการป้องกันภาวะเซลล์ต้นกำเนิดใหม่ต่อต้านร่างกาย (graft-versus-host disease: GVHD) เภสัชกรมีบทบาทหน้าที่ในการตรวจสอบความถูกต้องของใบสั่งยา ผสมยาเคมีบำบัด และช่วยป้องกันภาวะแทรกซ้อนอื่น ๆ ที่อาจเกิดขึ้นจากยา preparative regimens ได้ เช่น การใช้ยาป้องกันอาการคลื่นไส้อาเจียนจากยาเคมีบำบัด การป้องกันเยื่อบุในช่องปากอักเสบ การใช้ยาป้องกันการชักจากยา busulfan การใช้ mesna ในการป้องกันการอักเสบและมีเลือดออกในกระเพาะปัสสาวะจากยา cyclophosphamide การช่วยติดตามและปรับระดับยาในเลือดของยา busulfan หรือยากดภูมิคุ้มกันชนิดต่าง ๆ ให้เป็นไปตามเป้าหมาย อีกทั้งยังช่วยป้องกันอันตรกิริยาระหว่างยาที่อาจเกิดขึ้น เพื่อให้ผู้ป่วยเกิดความปลอดภัยจากการใช้ยา
Article Details
บท
บทความวิจัย
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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17. Gratwohl A, Carreras E. Chapter 8: Principles of conditioning. In: Apperley J, Carreras E, Gluckman E, Masszi T, editors. ESH-EBMT handbook on haematopoietic stem cell transplantation 2012, 6th ed. Paris: European school of haematology; 2012. p.123-36.
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24. Tomblyn M, Chiller T, Einsele H, Gress R, Sepkowitz K, Storek J, et al. Guidelines for preventing infectious complications among hemato poietic cell transplant recipients: a global perspec tive. Preface Bone Marrow Transplant 2009;44: 1143-238.
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33. Ruutu T, Juvonen E, Remberger M, Remes K, Volin L, Mattsson J, et al. Improved survival with ursodeoxycholic acid prophylaxis in allogeneic stem cell transplantation: Long-term follow-up of a randomized study. Biol Blood Marrow Transplant 2014;20:135-8.
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39. Hastings CA, Torkildson JC, Agrawal AK. Chapter 24: Hematopoietic Stem Cell Transplantation. In: Hastings CA, Torkildson JC, Agrawal AK, editors. Handbook of pediatric hematology and oncology-children's hospital and research center Oakland. 2nd ed. UK: John Wiley & Sons; 2012. p.219
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2. Sanpakit K. Overview in pediatric hematopoietic stem cell transplantation. J Med Assoc Thai 2005; 88: 1147-51.
3. Sanpakit K, Tabjareon S, Akaniroj S, Torsuwan N, Veerakul G. Analysis of hospital charges for hema topoietic stem cell transplantation in pediatric patients during admission at Siriraj hospital. J Hematol Transfus Med 2010;20:127-34.
4. National Cancer Institute. Childhood hematopoietic cell transplantation (PDQ®)-health professional version [online]. 2017 [cited Dec 18, 2017]. Availa ble from: www.cancer.gov/types/childhood-cancers /child-hct-hp-pdq
5. Sahdev I, Abdel-Azim H. Chapter 31: HematopoIe tic stem cell transplantation. In: Lanzkowsky P, editor. Manual of pediatric hematology and oncology. 6th ed. San Diego: Academic press; 2016. p. 577-604.
6. Phamorn W, Sanpakit K, Kupatawintu P, Aimyong N. The probability of finding an unrelated donor for stem cell waiting list patients at national blood center, Thai Red Cross Society. J Hematol Trans fus Med 2017;27:127-35.
7. Romphruk A. The importance of HLA antigen. J Hematol Transfus Med 2004;14:151-6.
8. Hirankarn N. Guideline for selecting donors for hematopoietic stem cell transplantation. J Hematol Transfus Med 2015;25:175-8.
9. Howard CA, Fernandez-Vina MA, Appelbaum FR, Confer DL, Devine SM, Horowitz MM, et al. Recommendations for donor human leukocyte antigen assessment and matching for allogeneic stem cell transplantation: consensus opinion of the Blood and Marrow Transplant Clinical Trials Network (BMTCTN). Biol Blood Marrow Transplant 2015;21:4-7.
10. Liewer S, Perkins J. Chapter 140: Hematopoietic stem cell transplantation. In: DiPiro JT editor, et al. Pharmacotherapy: A pathophysiologic approach. 10th ed. New York: McGraw-Hill Companies; 2017. p. 2305-21.
11. Motabi IH, DiPersio JF. Advances in stem cell mobilization. Blood Rev 2012;26:267-78.
12. Gluckman E. Chapter 6: Choice of the donor according to HLA typing and stem cell source. In: Apperley J, Carreras E, Gluckman E, Masszi T, editors. ESH-EBMT handbook on haematopoietic stem cell transplantation 2012, 6th ed. Paris: European school of haematology; 2012. p.93.
13. D’Souza A, Pasquini MC, Zhu X. Current use and outcome of hematopoietic stem cell transplantation: CIBMTR summary slides [online]. 2016 [cited Dec 18, 2017]. Available from: www.cibmtr.org
14. Ljungman P, Bregni M, Brune M, Cornelissen J, de Witte T, Dini G, et al. Allogeneic and autologous transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe 2009. Bone Marrow Transplant 2010;45: 219-34.
15. Gratwohl A, Baldomero H, Sureda A. Chapter 18: Indications for and current practice of allogeneic and autologous HSCT. In: Apperley J, Carreras E, Gluckman E, Masszi T, editors. ESH-EBMT hand book on haematopoietic stem cell transplantation 2012, 6th ed. Paris: European School of Haemato logy; 2012. p.306.
16. Majhail NS, Farnia SH, Carpenter PA, Champlin RE, Crawford S, Marks DI, et al. Indications for autologous and allogeneic hematopoietic cell transplantation: guidelines from the American Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2015;21:1863-9.
17. Gratwohl A, Carreras E. Chapter 8: Principles of conditioning. In: Apperley J, Carreras E, Gluckman E, Masszi T, editors. ESH-EBMT handbook on haematopoietic stem cell transplantation 2012, 6th ed. Paris: European school of haematology; 2012. p.123-36.
18. Green KGE, Rogosheske JR. Chapter 96: Hematopoietic cell transplantation. In: Alldredge BK et al., editor, Koda-Kimble and Young’s applied therapeutics: the clinical use of drugs. 10th ed. Philadelphia: Lippincott Williams &Wilkins; 2013. p. 2236-64.
19. Bensinger WI. Chapter 20: High-dose preparatory regimens. In: Forman SJ, Negrin RS, Antin JH, Appelbaum FR, editors. Thomas' hematopoietic cell transplantation, 4th ed. UK: Wiley-Blackwell Publish ing Chichester; 2016, p. 224.
20. Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V, et al. Defining the intensity of conditioning regimens: working definitions. Biol Blood Marrow Transplant 2009;15:1628-33.
21. National Comprehensive Cancer Network. Chronic myelogenous leukemia [online]. 2018 [cited Apr 19, 2018]. Available form: www.nccn.org/professionnal s/physician_gls /pdf/cml .pdf
22. Carracedo C, Lawson AP. Chapter 98: HematopoI etic stem cell transplantation. In: Chisholm-Burns MA, Schwinghammer TL, Wells BG, Malone PM, Kolesar JM, Dipiro JT, editors. Pharmacotherapy principles & practice. 4th ed. New York: McGraw-Hill Companies; 2016. p.1445-59.
23. Lowsky R, Messner H. Chapter 77: Mechanisms and treatment of graft failure. In: Forman SJ, Negrin RS, Antin JH, Appelbaum FR, editors. Thomas' hematopoietic cell transplantation, 4th ed. UK: Wiley-Blackwell Publishing Chichester; 2016, p. 944-54.
24. Tomblyn M, Chiller T, Einsele H, Gress R, Sepkowitz K, Storek J, et al. Guidelines for preventing infectious complications among hemato poietic cell transplant recipients: a global perspec tive. Preface Bone Marrow Transplant 2009;44: 1143-238.
25. Ardura MI. Overview of infections complicating pediatric hematopoietic cell transplantation. Infect Dis Clin N Am 2018;32:237-52.
26. Bride KL, Levy E, Wohlschlaeger A, Freedman JL. Chapter 17: Infectious complications and HSCT. In: Brown VL editor. Hematopoietic stem cell transplan tation for the pediatric hematologist/oncologist. USA: Springer International Publishing AG; 2018. p. 241-55.
27. Pasquini MC, Zhu X. Current use and outcome of hematopoietic stem cell transplantation: CIBMTR summary slides [online]. 2012 [cited Apr 19, 2018]. Available format: www.cibmtr.org
28. National Comprehensive Cancer Network. Preven tion and treatment cancer related infection [online]. 2018. [cited 2018 Apr 21]. Available form: www.nc cn.org/professionals/physician_gls/pdf/infections.pdf
29. UpToDate. Busulfan: Pediatric drug information. [Online]. 2017 [cited Dec 18, 2017]. Available from:www.uptodate.com/contents/busulfan-pediatric -drug-information.
30. Dignan FL, Wynn RF, Hadzic N, Karani J, Quaglia A, Pagliuca A et al. BCSH/BSBMT guideline: diag nosis and management of veno-occlusive disease (sinusoidal obstruction syndrome) following haematopoietic stem cell transplantation. Br J Haematol 2013;163:444-57.
31. Corbacioglu S, Cesaro S, Faraci M, Valteau-Couanet D, Gruhn B, Rovelli A et al. Defibrotide for prophylaxis of hepatic veno-occlusive disease in paediatric haemopoietic stem-cell transplantation: an open-label, phase 3, randomized controlled trial. Lancet 2012;379:1301-09.
32. Tay J, Tinmouth A, Fergusson D, Huebsch L, Allan DS. Systematic review of controlled clinical trials on the use of ursodeoxycholic acid for the prevention of hepatic venoocclusive disease in hematopoietic stem cell transplantation. Biol Blood Marrow Trans plant 2007;13:206-17.
33. Ruutu T, Juvonen E, Remberger M, Remes K, Volin L, Mattsson J, et al. Improved survival with ursodeoxycholic acid prophylaxis in allogeneic stem cell transplantation: Long-term follow-up of a randomized study. Biol Blood Marrow Transplant 2014;20:135-8.
34. MIMS Thailand. Ursodeoxycholic acid [online]. 2018 [cited 20 Apr, 2018]. Available from: www. mims.com/thailand/drug/info/ursodeoxycholic%20aci d/?type=brief&mtype=generic
35. European medicines agency. Defibrotide: summary of product characteristics [online]. 2017 [cited Apr 17, 2018]. Available from: www.ema.europa.eu/doc s/en_GB/document_library/EPAR_-_Product_Inform ation/human/002393/WC500153150.pdf
36. Richardson PG, Riches ML, Kernan NA, Brochstein JA, Mineishi S, Termuhlen AM, et al. Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure. Blood 2016;127:1656-65.
37. Al Beihany A, Al Omar H, Sahovic E, Chaudhri N, Al Mohareb F, Al Sharif F, et al. Successful treatment of hepatic veno-occlusive disease after myeloablative allogeneic hematopoietic stem cell transplantation by early administration of a short course of methylprednisolone. Bone Marrow Trans plant 2008;41:287-91.
38. Myers KC, Lawrence J, Marsh RA, Davies SM, Jodele S. High-dose methylprednisolone for veno-occlusive disease of the liver in pediatric hemato poietic stem cell transplantation recipients. Biol Blood Marrow Transplant 2013;19:500-3.
39. Hastings CA, Torkildson JC, Agrawal AK. Chapter 24: Hematopoietic Stem Cell Transplantation. In: Hastings CA, Torkildson JC, Agrawal AK, editors. Handbook of pediatric hematology and oncology-children's hospital and research center Oakland. 2nd ed. UK: John Wiley & Sons; 2012. p.219
40. Hensley ML, Hagerty KL, Kewalramani T, Green DM, Meropol NJ, Wasserman TH, et al. American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants. J Clin Oncol 2009; 27:127-45.
41. Electronic medicines compendium. Mesna injection [online]. 2014 [cited Apr 17, 2018]. Available from: www.medicines.org.uk/emc/product/1838/smpc
42. Carless PA. WHO EML: final report-mesna (sodium 2-mercaptoethane sulfonate) [online]. 2008 [cited Apr 17, 2018]. Available from: www.who.int/selec tion_medicines/committees/expert/17/application/mesna_ inclusion.pdf
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