Blood collection technique for pharmacokinetic studies of doxorubicin in paediatric patients

Lobb, M., Norris, R. L. G., Charles, B., Gilshenan, K., Moore, A. and Pinkerton, R. (2011). Blood collection technique for pharmacokinetic studies of doxorubicin in paediatric patients. In: 12th International Congress of Therapeutic Drug Monitoring and Clinical Toxicology. 12th International Congress of Therapeutic Drug Monitoring and Clinical Toxicology, Stuttgart, Germany, (547-547). 2-6 October, 2011. doi:10.1097/01.ftd.0000400651.94145.ba


Author Lobb, M.
Norris, R. L. G.
Charles, B.
Gilshenan, K.
Moore, A.
Pinkerton, R.
Title of paper Blood collection technique for pharmacokinetic studies of doxorubicin in paediatric patients
Conference name 12th International Congress of Therapeutic Drug Monitoring and Clinical Toxicology
Conference location Stuttgart, Germany
Conference dates 2-6 October, 2011
Proceedings title 12th International Congress of Therapeutic Drug Monitoring and Clinical Toxicology   Check publisher's open access policy
Journal name Therapeutic Drug Monitoring   Check publisher's open access policy
Place of Publication Philadelphia PA, United States
Publisher Lippincott Wiliams & Wilkins
Publication Year 2011
Sub-type Published abstract
DOI 10.1097/01.ftd.0000400651.94145.ba
ISSN 0163-4356
1536-3694
Volume 33
Issue 4
Start page 547
End page 547
Total pages 1
Language eng
Formatted Abstract/Summary
Aims: To undertake a pharmacokinetic (PK) study of doxorubicin (dox) and its major metabolite doxorubicinol (doxol) in paediatric patients, blood samples were drawn from the indwelling catheter through which the dosage had been administered. Despite rinsing, contamination was apparent up to the third blood collection after dosing, in some cases, as demonstrated by the presence of a pinkish hue in the saline wash solution. The aim of this study was to assess the suitability of the flushing protocol used for PK studies and identify contaminated samples.

Methods:
After dosage administration, blood samples were collected via the same indwelling line as used to administer the dose. Saline was used to flush the line and a small volume of whole blood subsequently drawn through (discard), prior to each sample. The discard and samples were stored at – 70 °C until assayed by HPLC for dox and doxol. These data was collected on a total of 24 occasions from 19 different patients. On each occasion a total of six samples were collected at nominal times of pre-dose 1, 2, 3, 4 and 6 hours post-dose. The ratios of dox/doxol were then tabulated for both the samples and discards. Empirical criteria were applied to accept/reject samples based on the comparability of dox/doxol ratios between samples and discards. Statistical analysis for outliers using Grubbs’ test (extreme studentized deviate) was also performed on the data.

Results: Of the 144 samples tested, 21 samples were identified as contaminated using the empirical criteria. Of these, 17 were also identified statistically as being potentially contaminated. No samples were identified statistically that had not been identified using the empirical criteria. Conclusion: Dox appears to bind strongly to the
lumen of the catheter and adequate rinsing is required to prevent contamination of samples. Adequate training of phlebotomists will also be required to ensure the procedures are followed.
Keyword Pharmacokinetics
Blood collection
Doxorubicin
Q-Index Code CX
Q-Index Status Confirmed Code
Institutional Status UQ

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