ABSTRACT
OBJECTIVE: To explore the application of pharmacogenomics, drug interaction analysis, and therapeutic drug monitoring in the pharmaceutical care of patients with aplastic anemia. METHODS: Clinical pharmacists provided pharmaceutical care to one patient with aplastic anemia including estimation of cyclosporine (CsA) dose using pharmacogenomic test result, increasing the blood CsA concentrations by taking advantage of drug interactions, blood concentration monitoring, medication education and so on. RESULTS: Clinical pharmacists made rational suggestions, and satisfactory therapeutic effect was finally achieved. CONCLUSION: Clinical pharmacists can play an active role in clinical treatment by joining clinical teams and providing individualized pharmaceutical care.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of rituximab on B-lymphocytes and anti-platelet glycoprotein-specific antibodies in patients with refractory primary immune thrombocytopenic (ITP).</p><p><b>METHODS</b>Thirty-one ITP patients with a median age of 36 years (range 16 - 56 years) received solely intravenous rituximab at the dose of 375 mg/m(2) once weekly for consecutive 4 weeks. Lab studies included complete blood count, serum concentrations of IgG, IgM and IgA. CD3(+), CD4(+), CD8(+), CD19(+) and CD20(+) cell numbers were assayed by flow cytometry and anti-platelet glycoprotein-specific antibodies (GPIIb/IIIa, GPIb/IX) were assayed by monoclonal antibody-specific immobilisation of platelet antigens (MAIPA) prior to and following rituximab therapy. The response was evaluated according to the response criteria of international working group of ITP.</p><p><b>RESULTS</b>Complete responses were achieved in 12 cases, response in 7 cases, and no response in 12 cases. Responses were sustained 2 to 28 months (median 6 months) with 4 cases relapsed. After 4 weeks of rituximab therapy, GPIIb/IIIa and GPIb/IX disappeared in responded patients, and CD 19(+)/CD20(+) cells were almost depleted in all patients. As expected, the serum concentrations of IgG, IgM, IgA, and the T cell counts were not changed after therapy. Four patients developed infusion-related reaction, 1 impaired renal function, and 3 secondary infections.</p><p><b>CONCLUSION</b>Rituximab is effective and safe, and the adverse reaction is tolerable.</p>