RESUMO
Ivosidenib and enasidenib are targeted agents that inhibit mutant isocitrate dehydrogenase (IDH) enzymes, restoring normal cellular differentiation in affected acute myeloid leukemia patients. Both agents carry a risk of differentiation syndrome (DS), a potentially life-threatening complication. In this multicenter, retrospective study we sought to determine the real-world incidence and characterize DS in patients with a myeloid malignancy treated with an IDH inhibitor. Of 49 total patients, 15 patients (31%) had a documented diagnosis of DS and 8 patients (16%) met the criteria of DS by Montesinos, et al. The most common signs and symptoms of DS were dyspnea/hypoxia (56%), unexplained fever (56%), bone pain/arthralgia (44%), edema/weight gain (39%), and pleural/pericardial effusions (33%). Our study reports a higher real-world incidence of DS in patients treated with IDH inhibitors for myeloid malignancies than previously reported.
Assuntos
Antineoplásicos , Leucemia Mieloide Aguda , Antineoplásicos/uso terapêutico , Inibidores Enzimáticos/efeitos adversos , Humanos , Isocitrato Desidrogenase/genética , Leucemia Mieloide Aguda/diagnóstico , Mutação , Estudos Retrospectivos , SíndromeRESUMO
OBJECTIVE: To address the public health concern of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission, various intrapersonal and organizational factors were identified to explore opportunities for pharmacists as part of a HIV/HCV prevention strategy. The awareness and comfort of pharmacists practicing in independent pharmacies and student pharmacists on providing HIV and HCV point-of-care (POC) tests in an urban setting were investigated. METHOD: Surveys were anonymously completed by pharmacists practicing in independent pharmacies within a 2-mile radius of our institution and student pharmacists attending our institution. Surveys were administered over a period of 10 weeks. Data were analyzed using descriptive statistics. RESULTS: A total of 119 pharmacy students and 23 practicing licensed pharmacists completed the survey. Only 21.7% of pharmacists were aware that HIV and HCV screenings are available as POC tests. Pharmacists were more likely to feel comfortable administering other POC tests and not HIV or HCV POC tests. Student pharmacists felt more comfortable than pharmacists in administering HIV and HCV POC tests and had a higher perceived level of comfort of their ability to administer these tests as licensed pharmacists. CONCLUSIONS: In this urban setting, awareness and comfort in pharmacist-provided HIV and HCV POC testing is low, however, with proper training and education, pharmacists in these community pharmacy practice settings can expand HIV and HCV screening opportunities for the community.