A case report of acute lymphoblastic leukenmia after operation of congenital biliary atresia.:Pharmacokinetic Study of Antileukemic Drugs
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We report a 15-year-old girl with acute lymphoblastic leukemia who had undergone Kasai's operation for congenital biliary atresia. She had obstructive liver dysfunction and suffered from severe side effect on antileukemic drugs. So we examined pharmacokinetics of antileukemic drugs. We examined the plasma disappearance rate of ICG as the index of liver blood flow and pharmacokinetic study of caffeine and acetaminophen as the index of residual liver drug metabolic ability. Caffeine is mainly metabolized by cytochrome P450-mediated metabolism (phase 1 reaction), and the half-life of caffeine was prolonged. Acetaminophen is excreted mainly as glucuronide conjugation (phase 2 reaction), and the half-life of acetaminophen was prolonged. We twice examined pharmacokinetics of 6MP, but we could not calculate the half-life of 6MP because of absorption delay. The half-life of prednisolone was 1.7 times as acetaminophen. Methotrexate is excreted from kidney without hepatic biotransformation. So the half-life of MTX (β phase) was 1.5 hr and it was within normal range. The examination of pharmacokinetic study of caffeine and acetaminophen is the index of own liver drug metabolic ability and can avoid severe side effect. We can decide optimal dosage for the patient.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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