[Pharmacokinetics of BHAC, VP-16 and Ara-C derived from BHAC in a hemodialysed patient with AMMoL].
Although recently the occurrence of a malignant neoplasma as a complication of uremia is becoming more frequently, pharmacokinetics of antitumor agents are not precisely studied in patients with impaired renal function. In this report we investigated pharmacokinetics of enositabine (BHAC), arabinosylcytosine (Ara-C) and etoposide (VP-16) in a patient on maintenance hemodialysis who suffered from acute myelomonocytic leukemia and treated by BHAC-EV regimen. Pharmacokinetic parameters of BHAC in uremia were not different from that in patients with normal renal function, and hemodialysis did not affect on the plasma level of BHAC. No significant accumulation of Ara-C was seen in uremia, but there remained the possibility that Ara-C could be removed by hemodialysis. So BHAC was able to be used in uremic patients safely. Since VP-16 was proved to be not a hemodialyzable but an accumulative substance and prolongation of plasma half life was prompt in uremia, VP-16 should be administered to uremic patients very cautiously. From these results BHAC-EV regimen was presumed to be a safely, well tolerated and beneficial regimen in uremic patients.
Kaito
K
K
Second Department of Internal Medicine, Jikei University School of Medicine.
Kobayashi
M
M
Katayama
T
T
Ochiai
S
S
Yoshida
M
M
Masuoka
H
H
Shimada
T
T
Nishiwaki
K
K
Saito
A
A
Watanabe
R
R
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics*; D005047:Etoposide / Q000008:administration & dosage / Q000493:pharmacokinetics*; D006801:Humans; D015479:Leukemia, Myelomonocytic, Acute / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D006435:Renal Dialysis; D014511:Uremia / Q000150:complications / Q000628:therapy; D014751:Vindesine / Q000008:administration & dosage
D003561:Cytarabine; D005047:Etoposide; C015019:enocitabine; D014751:Vindesine