Ayşe GÜNAY, Eren DEMİRPOLAT, Betul AYCAN, Ali ÜNAL

Hematopoietik Kök Hücre Nakli Türüne ve Nakil Öncesi Mevcut Polifarmasiye Bağlı Olarak İlaç-İlaç Etkileşimi Farklılıkları

Amaç: İlaç ilaç etkileşimleri, kök hücre nakli işleminin başarısını etkileyebilmektedir. Bu nedenle, bu etkileşimlerin riskini analiz etmek sağlık profesyonelleri için gerekliliktir. Bu çalışma, allojenik ve otolog kök hücre nakli hastalarında nakil öncesi ve sonrası ilaç-ilaç etkileşimlerini belirlemek amacıyla yapılmıştır. Material and Methods: Çalışmaya allojenik kök hücre nakli ve otolog kök hücre nakli yapılan hastalar dahil edildi. Hastaların nakil gününden on gün önce, nakil gününde ve nakil gününden on gün sonrasına ait tedavi şemaları toplandı. İlaç-ilaç etkileşimleri, dört ilaç-ilaç etkileşimi kontrol veri tabanı kullanılarak analiz edildi. Bulgular: Her iki transplantasyon tipinden 50 hasta dahil edildi. Allojenik ve otolog nakiller için ortalama yaş sırasıyla 42.4 ve 51.8 idi. Allojenik nakillerin %52'si ve otolog nakillerin %28'i nakilden önceki onuncu günde ≥5 ilaç kullanıyordu. Allojenik ve otolog kök hücre nakli hastalarında ortalama etkileşim sayıları sırasıyla 75.42 ve 43.62 idi. Allojenik ve otolog nakil hastalarında sırasıyla %94 ve %92 oranında en az bir kontrendike etkileşimin saptandı. Allojenik nakillerin %48'inde ve otolog nakillerin %36'sında iki veya daha fazla kontrendike etkileşim tespit edildi. Sonuç: Allojenik kök hücre nakli hastaları, otolog kök hücre nakli hastalarına göre neredeyse iki kat daha fazla ilaç-ilaç etkileşimine maruz kaldı. Transplantasyon tipi, hastanın transplantasyon öncesi ve sonrası dönemde olması ve transplantasyon sürecinin başındaki ilaç sayısı ilaç-ilaç etkileşim sayısı açısından önemlidir. Transplantasyon tipi ve hastaların mevcut ilaçları açısından etkileşimlerin belirlenmesi önem arz etmektedir. Anahtar Kelimeler İlaç-ilaç etkileşimleri, hematopoietik kök hücre nakli, klinik eczacılık, HKHN, KİT

Anahtar Kelimeler:

İlaç-ilaç etkileşimleri, hematopoietik kök hücre nakli, klinik eczacılık, HKHN, KİT

Drug-Drug Interaction Intensity Differences Depending On The Hematopoietic Stem Cell Transplantation Type And Existing Polypharmacy Prior To Transplantation

Introduction: Drug drug interactions can effect the success of stem cell transplantation process. Therefore, analyzing the risk of these interactions would be helpful for practitioners. This study was conducted to identify drug-drug interactions in allogeneic and autologous stem cell transplantation patients before and after transplantation. Methods: Patients who underwent allogeneic stem cell transplantation and autologous stem cell transplantation were included in the study. Patients’ treatment sheets were collected ten days before transplantation day, on the transplantation day, and ten days after transplantation day. Drug-drug interactions were analyzed by using four drug-drug interaction checking databases. Results: 50 patients from both transplantation types were included. The mean ages for allogeneic and autologous transplants were 42.4 and 51.8, respectively. 52% of allogeneic transplants and 28% of autologous transplants were on ≥5 drugs at tenth day before transplantation. The means of interactions in allogeneic and autologous stem cell transplantation patients were 75.42 and 43.62, respectively. The detection of at least one contraindicated interaction in allogeneic and autologous transplant patients were 94% and 92%, respectively. In 48% of allogeneic transplants and 36% of autologous transplants, two or more contraindicated interactions were detected. Conclusion: Allogeneic stem cell transplantation patients experienced almost two times more drug-drug interactions than autologous stem cell transplantation patients. Transplantation type, being in the pre and post-transplantation period and the drug number at the beginning of the transplantation process matter in terms of the number of drug-drug interactions. Identifying interactions in terms of transplantation type and existing medications is very important.

Keywords:

Drug-drug interactions, hematopoietic stem cell transplantation, clinical pharmacy, HSCT, BMT,

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