Abstract：
This study aimed to evaluate the utilization of drugs with pharmacogenomic guidelines (PGx-drugs) for personalized dosing in pediatric leukemia. A retrospective observational study of pediatric leukemia patients admitted between 2009-2019 at a single-center academic children\'s hospital was conducted to determine PGx-drug exposure within 3 years of diagnosis. Along with baseline demographic and clinical characteristics of these patients, data regarding dates of diagnosis, relapse, death were collected. During the study period, inclusion criteria were met by 714 patients. The most frequently given medications were ondansetron (96.1%), morphine (92.2%), and allopurinol (85.3%) during the study period. In this cohort, 82% of patients received five or more PGx-drugs. Patients diagnosed with acute myeloid leukemia and leukemia unspecified were prescribed more PGx-drugs than other types of leukemia. There was a significant relationship between age at diagnosis and the number of PGx-drugs prescribed. Adolescents and adults both received a median of 10 PGx-drugs, children received a median of 6 PGx-drugs, and infants received a median of 7 PGx-drugs (p < 0.001). Patients with recurrent leukemia had significantly more PGx-drugs prescribed compared to those without recurrent disease, 10 drugs and 6 drugs, respectively (p < 0.001). Patients diagnosed with childhood leukemia are high utilizers of PGx-drugs. There is a vital need to understand how PGx testing may be utilized to optimize treatment and enhance quality of life. Preemptive PGx testing is a tool that aids in optimization of drug therapy and decreases the need for later treatment modifications. This can result in financial savings from decreased health-care encounters.
摘要：
这项研究旨在评估药物基因组指南（PGx药物）在小儿白血病中个性化给药的应用。对2009-2019年间在单中心学术儿童医院收治的儿童白血病患者进行了一项回顾性观察研究，以确定诊断后3年内PGx药物暴露。除了这些患者的基线人口统计学和临床特征，有关诊断日期的数据，复发,死亡被收集。在学习期间,714例患者符合纳入标准.最常服用的药物是昂丹司琼（96.1%），吗啡（92.2%），和别嘌呤醇（85.3%）在研究期间。在这个队列中，82%的患者接受了5种或更多的PGx药物。与其他类型的白血病相比，被诊断为急性髓细胞性白血病和未指明白血病的患者服用了更多的PGx药物。诊断时的年龄与处方的PGx药物数量之间存在显着关系。青少年和成年人都接受了10种PGx药物的中位数，儿童接受了6种PGx药物的中位数，婴儿接受的PGx药物中位数为7种(p<0.001).与没有复发性疾病的患者相比，复发性白血病患者处方的PGx药物明显更多，10种药物和6种药物，分别(p<0.001)。诊断为儿童白血病的患者是PGx药物的高利用率。迫切需要了解如何利用PGx测试来优化治疗并提高生活质量。抢先PGx测试是一种工具，有助于优化药物治疗，并减少对后期治疗修改的需要。这可能会导致医疗保健服务减少而节省资金。
