PMID- 31741622
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 0971-4502 (Print)
IS  - 0974-0449 (Electronic)
IS  - 0971-4502 (Linking)
VI  - 35
IP  - 4
DP  - 2019 Oct
TI  - Factors Influencing the Safety and Efficiency of Antifungal Prophylaxis with 
      Posaconazole in Children with Hematological Diseases: From Genetics to 
      Polypharmacotherapy.
PG  - 699-706
LID - 10.1007/s12288-019-01134-5 [doi]
AB  - The aim of this study was to determine the impact of ABCB1 polymorphism, BMI, age 
      and drug co-administration on safety and efficiency of posaconazole (PCZ) oral 
      suspension treatment in children with hematological diseases. Seventy children 
      were included in the study. ABCB1 polymorphism in fifty-eight children was 
      determined using a PCR-RFLP method. A protocol with data on the health condition, 
      treatment and adverse events (AE), as well as a survey on treatment tolerance for 
      the legal guardians was evaluated. Liver function tests were observed for the 
      first 20 days, and AE during the complete medication period. For statistical 
      analysis a chi(2) test with Yates's correction, a Pearson's or Spearman's 
      correlation test was performed (p < 0.05). Genetic testing showed 24% CC, 46% CT 
      and 30% of TT variants. PCZ prophylaxis failed in twenty cases, where change in 
      prophylactic treatment was needed. Fifty-two children suffered from at least one 
      mild to moderate adverse event. Sixty-five legal guardians completed the survey, 
      most of them reported the treatment to be well tolerated. ABCB1 polymorphism had 
      no impact on AE occurrence and posaconazole prophylaxis efficiency. Age 
      influenced the number of gastrointestinal (p = 0.02), visual (p = 0.05), 
      neurological (p = 0.01), dermatological (p = 0.002) and flu-like (p = 0.02) 
      complications. AST (p = 0.03) and LDH (p = 0.008) activity presented age 
      dependency. The concomitant use of proton pump inhibitors (PPI) had impact on 
      liver health parameters elevation (p = 0.009) and circulatory system 
      complications (p = 0.008). High incidence of mild to moderate AE, and other 
      factors influencing PCZ pharmacokinetics (PPI co-administration, obesity), 
      suggest a need for careful pediatric onco-hematology patient evaluation.
CI  - (c) The Author(s) 2019.
FAU - Sienkiewicz-Oleszkiewicz, Beata
AU  - Sienkiewicz-Oleszkiewicz B
AUID- ORCID: 0000-0003-1912-0873
AD  - 1Department of Clinical Pharmacology, Faculty of Pharmacy, Wroclaw Medical 
      University, 211a Borowska St., 50-556 Wroclaw, Poland. GRID: grid.4495.c. ISNI: 
      0000 0001 1090 049X
FAU - Urbanczyk, Kamila
AU  - Urbanczyk K
AD  - 1Department of Clinical Pharmacology, Faculty of Pharmacy, Wroclaw Medical 
      University, 211a Borowska St., 50-556 Wroclaw, Poland. GRID: grid.4495.c. ISNI: 
      0000 0001 1090 049X
FAU - Stachowiak, Mateusz
AU  - Stachowiak M
AD  - 2Department of Paediatric Bone Marrow Transplantation, Oncology and Hematology, 
      Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland. GRID: 
      grid.4495.c. ISNI: 0000 0001 1090 049X
FAU - Rodziewicz, Anna
AU  - Rodziewicz A
AD  - 2Department of Paediatric Bone Marrow Transplantation, Oncology and Hematology, 
      Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland. GRID: 
      grid.4495.c. ISNI: 0000 0001 1090 049X
FAU - Zieba, Aleksander
AU  - Zieba A
AD  - 1Department of Clinical Pharmacology, Faculty of Pharmacy, Wroclaw Medical 
      University, 211a Borowska St., 50-556 Wroclaw, Poland. GRID: grid.4495.c. ISNI: 
      0000 0001 1090 049X
FAU - Kalwak, Krzysztof
AU  - Kalwak K
AD  - 2Department of Paediatric Bone Marrow Transplantation, Oncology and Hematology, 
      Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland. GRID: 
      grid.4495.c. ISNI: 0000 0001 1090 049X
FAU - Wiela-Hojenska, Anna
AU  - Wiela-Hojenska A
AD  - 1Department of Clinical Pharmacology, Faculty of Pharmacy, Wroclaw Medical 
      University, 211a Borowska St., 50-556 Wroclaw, Poland. GRID: grid.4495.c. ISNI: 
      0000 0001 1090 049X
LA  - eng
PT  - Journal Article
DEP - 20190514
PL  - India
TA  - Indian J Hematol Blood Transfus
JT  - Indian journal of hematology & blood transfusion : an official journal of Indian 
      Society of Hematology and Blood Transfusion
JID - 9425818
PMC - PMC6825114
OTO - NOTNLM
OT  - ABCB1 protein
OT  - Adverse drug event
OT  - Children
OT  - Hematology
OT  - Posaconazole
COIS- Conflict of interestThe authors declare that they have no conflict of interest.
EDAT- 2019/11/20 06:00
MHDA- 2019/11/20 06:01
PMCR- 2019/05/14
CRDT- 2019/11/20 06:00
PHST- 2018/10/03 00:00 [received]
PHST- 2019/05/06 00:00 [accepted]
PHST- 2019/11/20 06:00 [entrez]
PHST- 2019/11/20 06:00 [pubmed]
PHST- 2019/11/20 06:01 [medline]
PHST- 2019/05/14 00:00 [pmc-release]
AID - 1134 [pii]
AID - 10.1007/s12288-019-01134-5 [doi]
PST - ppublish
SO  - Indian J Hematol Blood Transfus. 2019 Oct;35(4):699-706. doi: 
      10.1007/s12288-019-01134-5. Epub 2019 May 14.