Early Therapeutic Drug Monitoring of Posaconazole Oral Suspension in Patients With Hematologic Malignancies

Background: Therapeutic drug monitoring (TDM) of posaconazole is usually performed 1 week after starting the drug because of its long half-life. However, previous studies showed that measuring the posaconazole plasma concentration (PPC) on day 3 is effective for predicting steady-state levels. The purpose of this study was to evaluate the relevance of early TDM (day 3) of posaconazole for achieving an optimal PPC. Methods: This prospective study was conducted from September 2014 to August 2016. A total of 148 patients with acute myeloid leukemia or myelodysplastic syndromes received a 200 mg posaconazole oral suspension 3 times daily for fungal prophylaxis. During the period from September 2014 to December 2015 (control group), no dose adjustment was performed on day 3. During the period from January 2016 to Aug 2016 (early TDM group), the frequency of posaconazole 200-mg administration was increased to 4 times daily in patients whose PPC on day 3 was
Source: Therapeutic Drug Monitoring - Category: Drugs & Pharmacology Tags: Original Article Source Type: research

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Authors: Rahmé R, Adès L Abstract INTRODUCTION: Myelodysplastic syndromes (MDS) are clonal stem cell disorders mostly affecting the elderly. They are classified into lower and higher risk MDS according to prognostic scoring systems. In higher-risk patients, treatments should aim to modify the disease course by avoiding progression to acute myeloid leukemia, and therefore to improve survival. Areas covered: Stem cell transplantation remains the only curative treatment when feasible, but this concerns a small minority of patients. Treatment is principally based on hypomethylating agents (HMAs). Our unde...
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
Conclusion: The "Clo-Baltimore regimen" is safe and feasible and provides good survivals for patients with myeloid malignancies and haplo-donors. Methods: Here, we report a variant of the Baltimore regimen, where 1) fludarabine was replaced by clofarabine, 2) bone marrow was replaced by peripheral blood stem cells, and 3) tacrolimus was replaced by cyclosporine, in a "Clo-Baltimore regimen". PMID: 30323896 [PubMed]
Source: Oncotarget - Category: Cancer & Oncology Tags: Oncotarget Source Type: research
Disease relapse after allogeneic hematopoietic cell transplant (allo-HCT) remains the most common cause of mortality for patients with myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) (1). Assessment and monitoring of minimal residual disease (MRD) in these patients is often challenging because of heterogeneity of malignant clones, and the absence of well-standardized MRD assays. Chimerism analysis by the characterization of short tandem repeat (STR) markers in subpopulations of peripheral blood (PB) cells is currently widely used to monitor engraftment status and disease relapse after allo-HCT.
Source: Leukemia Research - Category: Hematology Authors: Source Type: research
Purpose of review Myelodysplastic syndromes (MDSs) are rare disorders in children, showing peculiar clinical manifestations and biological features. This review will summarize biological, genetic and clinical features of childhood MDS and will provide an update of the algorithm of treatment of the different disease variants. Recent findings The most recent classification of MDS includes refractory cytopenia of childhood (RCC), advanced and therapy-related MDS. Importantly, in children, these clonal hematopoietic disorders may be often associated with inherited bone marrow failure syndromes, this representing a challen...
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: HEMATOLOGIC MALIGNANCIES: Edited by Miguel A. Sanz Source Type: research
Relative survival following response to 7 + 3 versus azacytidine is similar in acute myeloid leukemia and high-risk myelodysplastic syndromes: an analysis of four SWOG studiesRelative survival following response to 7 + 3 versus azacytidine is similar in acute myeloid leukemia and high-risk myelodysplastic syndromes: an analysis of four SWOG studies, Published online: 12 October 2018; doi:10.1038/s41375-018-0275-xRelative survival following response to 7 + 3 versus azacytidine is similar in acute myeloid leukemia and high-risk myelodysplastic syndromes: an analysis of four SWOG studies
Source: Leukemia - Category: Hematology Authors: Source Type: research
The integration of genetic data into the clinical and pathological assessment of myeloid neoplasms underscores the expanding role of genomic changes in the diagnosis, prognosis, classification and therapeutic implications of precision medicine. Myeloid neoplasms include myelodysplastic syndrome (MDS), myelodysplastic/ myeloproliferative neoplasm (MDS/MPN), myeloproliferative neoplasm (MPN) and acute myeloid leukemia (AML). The myelodysplastic syndromes (MDS) comprise a very heterogeneous group of clonal myeloid disorders characterized by peripheral blood cytopenias, a bone marrow aspirate/biopsy showing dysplasia in one or...
Source: Cancer Genetics and Cytogenetics - Category: Genetics & Stem Cells Authors: Tags: Review Article Source Type: research
Conclusions: G-CSF for patients with AA is not associated with a higher occurrence of secondary malignant neoplasm, mainly MDS/AML, or PNH.Acta Haematol 2018;140:141 –145
Source: Acta Haematologica - Category: Hematology Source Type: research
Purpose of review The monitoring of minimal residual disease (MRD) has important clinical implications in both the pre and postallogeneic stem cell transplant (SCT) setting in acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Next-generation sequencing (NGS) is a rapidly improving technology whose application to the monitoring of MRD is an active area of research. We aim to describe existing methods of MRD in AML and MDS, with a focus on the utility of NGS in patients undergoing SCT. Recent findings Flow cytometry and quantitative PCR have been recommended by the European Leukemia Net as the preferred m...
Source: Current Opinion in Hematology - Category: Hematology Tags: HEMATOPOIETIC STEM CELL TRANSPLANTATION: Edited by Armand Keating Source Type: research
(University of Texas M. D. Anderson Cancer Center) The University of Texas MD Anderson Cancer Center and Cyclacel Pharmaceuticals, Inc., today announced a three-year strategic alliance agreement that will enable clinical evaluation for safety and efficacy of three Cyclacel medicines in patients with hematological malignancies, including chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) and other advanced leukemias.
Source: EurekAlert! - Cancer - Category: Cancer & Oncology Source Type: news
In this study, genetic mouse models and patient-derived xenografts (PDX) demonstrated that Jarid2 acts as a tumor suppressor in chronic myeloid disorders. Genetic deletion of Jarid2 either reduced overall survival of MPN, or drove transformation to sAML, depending on the timing and context of co-operating mutations. Mechanistically, Jarid2 recruits PRC2 to epigenetically repress self-renewal pathways in hematopoietic progenitor cells. These studies establish Jarid2 as a bona fide hematopoietic tumor suppressor and highlight new therapeutic targets.
Source: GEO: Gene Expression Omnibus - Category: Genetics & Stem Cells Tags: Expression profiling by high throughput sequencing Genome binding/occupancy profiling by high throughput sequencing Mus musculus Source Type: research
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