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- Title
Pharmacokinetic‐Pharmacodynamic Model of Neutropenia in Patients With Myeloma Receiving High‐Dose Melphalan for Autologous Stem Cell Transplant.
- Authors
Cho, Yu Kyoung; Irby, Donald J.; Li, Junan; Sborov, Douglas W.; Mould, Diane R.; Badawi, Mohamed; Dauki, Anees; Lamprecht, Misty; Rosko, Ashley E.; Fernandez, Soledad; Hade, Erinn M.; Hofmeister, Craig C.; Poi, Ming; Phelps, Mitch A.
- Abstract
High‐dose melphalan (HDM) is part of the conditioning regimen in patients with multiple myeloma (MM) receiving autologous stem cell transplantation (ASCT). However, individual sensitivity to melphalan varies, and many patients experience severe toxicities. Prolonged severe neutropenia is one of the most severe toxicities and contributes to potentially life‐threatening infections and failure of ASCT. Granulocyte‐colony stimulating factor (G‐CSF) is given to stimulate neutrophil proliferation after melphalan administration. The aim of this study was to develop a population pharmacokinetic/pharmacodynamic (PK/PD) model capable of predicting neutrophil kinetics in individual patients with MM undergoing ASCT with high‐dose melphalan and G‐CSF administration. The extended PK/PD model incorporated several covariates, including G‐CSF regimen, stem cell dose, hematocrit, sex, creatinine clearance, p53 fold change, and race. The resulting model explained portions of interindividual variability in melphalan exposure, therapeutic effect, and feedback regulation of G‐CSF on neutrophils, thus enabling simulation of various doses and prediction of neutropenia duration.
- Subjects
PHARMACOKINETICS; PHARMACODYNAMICS; NEUTROPENIA; STEM cell transplantation; P53 protein
- Publication
CPT: Pharmacometrics & Systems Pharmacology, 2018, Vol 7, Issue 11, p748
- ISSN
2163-8306
- Publication type
Article
- DOI
10.1002/psp4.12345