{"id":13753,"date":"2019-08-04T16:25:31","date_gmt":"2019-08-04T09:25:31","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=13753"},"modified":"2025-01-09T08:32:07","modified_gmt":"2025-01-09T01:32:07","slug":"bendamustine-ribomustin","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/","title":{"rendered":"Bendamustine &#8211; Ribomustin"},"content":{"rendered":"<h1><span class=\"ez-toc-section\" id=\"thong-tin-to-huong-dan-su-dung-cua-thuoc-ribomustin\"><\/span>Th\u00f4ng tin t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a thu\u1ed1c Ribomustin<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p><em>Ribomustin l\u00e0 thu\u1ed1c ph\u00e1t minh hay c\u00f2n g\u1ecdi l\u00e0 bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c do c\u00f4ng ty Oncotec Pharma Produktion GmbH s\u1ea3n xu\u1ea5t v\u00e0 h\u00e3ng Janssen &#8211; Cilag Ltd \u0111\u0103ng k\u00fd. Thu\u1ed1c Ribomustin c\u00f3 ch\u1ee9a th\u00e0nh ph\u1ea7n ch\u00ednh l\u00e0 Bendamustine thu\u1ed9c nh\u00f3m thu\u1ed1c tr\u1ecb ung th\u01b0, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh b\u1ea1ch c\u1ea7u lympho m\u1ea1n t\u00ednh, u lympho kh\u00f4ng Hodgkin v\u00e0 b\u1ec7nh \u0111a u t\u1ee7y. Ngo\u00e0i ra thu\u1ed1c c\u0169ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh kh\u00e1c m\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea trong t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng d\u01b0\u1edbi \u0111\u00e2y. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 n\u1ed9i dung t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a Thu\u1ed1c Ribomustin (Th\u00f4ng tin bao g\u1ed3m li\u1ec1u d\u00f9ng, c\u00e1ch d\u00f9ng, ch\u1ec9 \u0111\u1ecbnh, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, th\u1eadn tr\u1ecdng, d\u01b0\u1ee3c l\u00fd&#8230;):<\/em><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_81 ez-toc-wrap-left counter-hierarchy ez-toc-counter ez-toc-white ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">N\u1ed9i dung ch\u00ednh<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#thong-tin-to-huong-dan-su-dung-cua-thuoc-ribomustin\" >Th\u00f4ng tin t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng c\u1ee7a thu\u1ed1c Ribomustin<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#1-ten-hoat-chat-va-biet-duoc\" >1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#2-dang-bao-che-%e2%80%93-ham-luong\" >2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#3-thong-tin-danh-cho-nguoi-su-dung\" >3. Th\u00f4ng tin d\u00e0nh cho ng\u01b0\u1eddi s\u1eed d\u1ee5ng:<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#31-ribomustin-la-thuoc-gi\" >3.1. Ribomustin l\u00e0 thu\u1ed1c g\u00ec?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#32-cau-hoi-thuong-gap-pho-bien\" >3.2. C\u00e2u h\u1ecfi th\u01b0\u1eddng g\u1eb7p ph\u1ed5 bi\u1ebfn:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#4-thong-tin-danh-cho-nhan-vien-y-te\" >4. Th\u00f4ng tin d\u00e0nh cho nh\u00e2n vi\u00ean y t\u1ebf:<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#41-chi-dinh\" >4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#42-lieu-dung-%e2%80%93-cach-dung\" >4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#43-chong-chi-dinh\" >4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#44-than-trong\" >4.4 Th\u1eadn tr\u1ecdng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#45-su-dung-cho-phu-nu-co-thai-va-cho-con-bu\" >4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#46-tac-dung-khong-mong-muon-adr\" >4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#47-huong-dan-cach-xu-tri-adr\" >4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#48-tuong-tac-voi-cac-thuoc-khac\" >4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#49-qua-lieu-va-xu-tri\" >4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#5-co-che-tac-dung-cua-thuoc\" >5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#51-duoc-luc-hoc\" >5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#52-duoc-dong-hoc\" >5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#53-hieu-qua-lam-sang\" >5.3. Hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#54-du-lieu-tien-lam-sang\" >5.4. D\u1eef li\u1ec7u ti\u1ec1n l\u00e2m s\u00e0ng:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#6-phan-thong-tin-kem-theo-cua-thuoc\" >6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#61-danh-muc-ta-duoc\" >6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#62-tuong-ky\" >6.2. T\u01b0\u01a1ng k\u1ef5 :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#63-bao-quan\" >6.3. B\u1ea3o qu\u1ea3n:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-26\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#64-thong-tin-khac\" >6.4. Th\u00f4ng tin kh\u00e1c :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-27\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#65-tai-lieu-tham-khao\" >6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-28\" href=\"https:\/\/pharmog.com\/wp\/bendamustine-ribomustin\/#7-nguoi-dang-tai-tac-gia\" >7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n<h2><span class=\"ez-toc-section\" id=\"1-ten-hoat-chat-va-biet-duoc\"><\/span><strong>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c:<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong><em>Ho\u1ea1t ch\u1ea5t :<\/em> <a href=\"https:\/\/pharmog.com\/wp\/bendamustine\/\">Bendamustine (Bendamustin)<\/a><\/strong><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u00f4\u0301c ch\u00f4\u0301ng ung th\u01b0 &gt; Ch\u1ea5t alkyl h\u00f3a.<\/em><\/p>\n<p><strong><em>Nh\u00f3m<\/em><\/strong> <strong><em>ph\u00e1p l\u00fd: <\/em><\/strong><em>Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine)<\/em><\/p>\n<p><strong><em>M\u00e3 ATC<\/em><\/strong> (Anatomical Therapeutic Chemical): L01AA09.<\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c:<\/em><\/strong> Ribomustin.<\/p>\n<p><strong><em>H\u00e3ng s\u1ea3n xu\u1ea5t <\/em><\/strong>: Oncotec Pharma Produktion GmbH.<\/p>\n<p><strong><em>H\u00e3ng \u0111\u0103ng k\u00fd<\/em><\/strong>: Janssen &#8211; Cilag Ltd.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h2><span class=\"ez-toc-section\" id=\"2-dang-bao-che-%e2%80%93-ham-luong\"><\/span><strong>2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng: <\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong><em>D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n<p>B\u1ed9t pha dung d\u1ecbch \u0111\u1eadm \u0111\u1eb7c \u0111\u1ec3 pha dung d\u1ecbch ttruy\u1ec1n t\u0129nh m\u1ea1ch. M\u1ed7i l\u1ecd ch\u1ee9a Bendamustin hydroclorid 25mg ho\u1eb7c 100mg.<\/p>\n<p><strong><em>H\u00ecnh \u1ea3nh tham kh\u1ea3o:<\/em><\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\"><strong><em>RIBOMUSTIN <\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i l\u1ecd b\u1ed9t pha ti\u00eam truy\u1ec1n c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Bendamustine HCl<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>25 mg<\/td>\n<\/tr>\n<tr>\n<td>T\u00e1 d\u01b0\u1ee3c<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>v\u1eeba \u0111\u1ee7 (Xem m\u1ee5c 6.1)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-60536\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/08\/word-image-13753-1.png\" alt=\"Ribomustin (Bendamustine)\" width=\"632\" height=\"575\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/08\/word-image-13753-1.png 732w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2019\/08\/word-image-13753-1-300x273.png 300w\" sizes=\"auto, (max-width: 632px) 100vw, 632px\" \/><\/p>\n<h2><span class=\"ez-toc-section\" id=\"3-thong-tin-danh-cho-nguoi-su-dung\"><\/span><strong>3. Th\u00f4ng tin d\u00e0nh cho ng\u01b0\u1eddi s\u1eed d\u1ee5ng:<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"31-ribomustin-la-thuoc-gi\"><\/span>3.1. Ribomustin l\u00e0 thu\u1ed1c g\u00ec?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ribomustin l\u00e0 thu\u1ed1c ph\u00e1t minh hay c\u00f2n g\u1ecdi l\u00e0 bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c do c\u00f4ng ty Oncotec Pharma Produktion GmbH s\u1ea3n xu\u1ea5t v\u00e0 h\u00e3ng Janssen &#8211; Cilag Ltd \u0111\u0103ng k\u00fd. Thu\u1ed1c Ribomustin c\u00f3 ch\u1ee9a th\u00e0nh ph\u1ea7n ch\u00ednh l\u00e0 Bendamustine thu\u1ed9c nh\u00f3m thu\u1ed1c tr\u1ecb ung th\u01b0, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh b\u1ea1ch c\u1ea7u lympho m\u1ea1n t\u00ednh, u lympho kh\u00f4ng Hodgkin v\u00e0 b\u1ec7nh \u0111a u t\u1ee7y. Ngo\u00e0i ra thu\u1ed1c c\u0169ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh kh\u00e1c m\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea trong t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng d\u01b0\u1edbi \u0111\u00e2y.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"32-cau-hoi-thuong-gap-pho-bien\"><\/span>3.2. C\u00e2u h\u1ecfi th\u01b0\u1eddng g\u1eb7p ph\u1ed5 bi\u1ebfn:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>\u0110i\u1ec1u tr\u1ecb b\u1eb1ng Bendamustine c\u00f3 g\u00e2y r\u1ee5ng t\u00f3c hay kh\u00f4ng ?<\/em><\/p>\n<p>R\u1ee5ng t\u00f3c do \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Bendamustine l\u00e0 r\u1ea5t hi\u1ebfm. N\u1ebfu c\u00f3 x\u1ea3y ra th\u00ec th\u01b0\u1eddng r\u1ea5t nh\u1eb9 v\u00e0 kh\u00f4ng d\u1ec5 \u0111\u1ec3 nh\u1eadn ra.<\/p>\n<p><em>Th\u00f4ng th\u01b0\u1eddng t\u00f4i ph\u1ea3i \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Bendamustine trong bao l\u00e2u ?<\/em><\/p>\n<p>Bendamustine \u0111\u01b0\u1ee3c d\u00f9ng trong 2 ng\u00e0y cho m\u1ed7i chu k\u1ef3 h\u00f3a tr\u1ecb v\u00e0 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng k\u00e9o d\u00e0i trong s\u00e1u th\u00e1ng.<\/p>\n<p>\u0110\u1ed1i v\u1edbi b\u1ec7nh b\u1ea1ch c\u1ea7u lymphocytic m\u00e3n t\u00ednh (CLL), Bendamustine \u0111\u01b0\u1ee3c d\u00f9ng v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2 c\u1ee7a chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb 28 ng\u00e0y. Chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u1eb7p l\u1ea1i t\u1edbi s\u00e1u l\u1ea7n, t\u1ea1o th\u00e0nh m\u1ed9t li\u1ec7u tr\u00ecnh \u0111i\u1ec1u tr\u1ecb s\u00e1u th\u00e1ng.<\/p>\n<p>\u0110\u1ed1i v\u1edbi u lympho kh\u00f4ng Hodgkin, Bendamustine \u0111\u01b0\u1ee3c d\u00f9ng v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2 c\u1ee7a chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb 21 ng\u00e0y. Chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u1eb7p l\u1ea1i t\u1edbi t\u00e1m l\u1ea7n, t\u1ea1o th\u00e0nh m\u1ed9t li\u1ec7u tr\u00ecnh \u0111i\u1ec1u tr\u1ecb s\u00e1u th\u00e1ng.<\/p>\n<p><em>Ribomustin (Bendamustine) c\u00f3 n\u1eb1m trong danh m\u1ee5c b\u1ea3o hi\u1ec3m y t\u1ebf \u1edf Vi\u1ec7t Nam kh\u00f4ng?<\/em><\/p>\n<p>Ribomustin c\u00f3 ch\u1ee9a ho\u1ea1t ch\u1ea5t Bendamustine, t\u00ednh t\u1edbi n\u0103m 2024 thu\u1ed1c n\u00e0y \u0111\u00e3 n\u1eb1m trong danh m\u1ee5c b\u1ea3o hi\u1ec3m y t\u1ebf \u1edf Vi\u1ec7t Nam. Tuy nhi\u00ean Qu\u1ef9 b\u1ea3o hi\u1ec3m y t\u1ebf ch\u1ec9 chi tr\u1ea3 50% t\u1ed5ng gi\u00e1 tr\u1ecb c\u1ee7a thu\u1ed1c, s\u1ed1 c\u00f2n l\u1ea1i (50%) ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i t\u1ef1 thanh to\u00e1n, \u0111\u1ed3ng th\u1eddi b\u1ea3o hi\u1ec3m c\u0169ng gi\u1edbi h\u1ea1n c\u00e1c ch\u1ec9 \u0111\u1ecbnh thanh to\u00e1n c\u1ee7a thu\u1ed1c n\u00e0y ch\u1ec9 bao g\u1ed3m: \u0111i\u1ec1u tr\u1ecb b\u1ec7nh b\u1ea1ch c\u1ea7u lymph\u00f4 m\u1ea1n binet B\/C kh\u00f4ng ph\u00f9 h\u1ee3p h\u00f3a tr\u1ecb v\u1edbi Fludarabin; U lymph\u00f4 kh\u00f4ng Hodgkin, di\u1ec5n ti\u1ebfn ch\u1eadm, ti\u1ebfn tri\u1ec3n sau \u0111i\u1ec1u tr\u1ecb v\u1edbi Rituximab.<\/p>\n<p><em>T\u00f4i kh\u00f4ng th\u1ec3 mua \u0111\u01b0\u1ee3c<\/em> <em>Ribomustin, hi\u1ec7n t\u1ea1i c\u00f3 thu\u1ed1c n\u00e0o c\u00f3 th\u1ec3 mua thay th\u1ebf \u0111\u01b0\u1ee3c kh\u00f4ng?<\/em><\/p>\n<p>T\u00ednh t\u1edbi n\u0103m 2024, Ribomustin l\u00e0 thu\u1ed1c bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c v\u00e0 l\u00e0 thu\u1ed1c t\u1ed1t nh\u1ea5t c\u00f3 ch\u1ee9a ho\u1ea1t ch\u1ea5t Bendamustine t\u1ea1i Vi\u1ec7t Nam, trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng mua \u0111\u01b0\u1ee3c Ribomustin th\u00ec v\u1eabn c\u00f3 m\u1ed9t s\u1ed1 lo\u1ea1i bi\u1ec7t d\u01b0\u1ee3c, thu\u1ed1c t\u01b0\u01a1ng t\u1ef1 thay th\u1ebf \u0111\u01b0\u1ee3c nh\u01b0: Bendamustin beta, Bendamustine Mylan, Bendamustine hydrochloride 180mg\/4ml concentrate for solution for infusion.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"4-thong-tin-danh-cho-nhan-vien-y-te\"><\/span><strong>4. Th\u00f4ng tin d\u00e0nh cho nh\u00e2n vi\u00ean y t\u1ebf: <\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"41-chi-dinh\"><\/span>4.1. Ch\u1ec9 \u0111\u1ecbnh:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>B\u1ec7nh b\u1ea1ch c\u1ea7u lympho m\u1ea1n: <\/em>\u0110i\u1ec1u tr\u1ecb b\u01b0\u1edbc m\u1ed9t cho b\u1ec7nh b\u1ea1ch c\u1ea7u lympho m\u1ea1n (giai \u0111o\u1ea1n B ho\u1eb7c C theo Binet) \u1edf b\u1ec7nh nh\u00e2n kh\u00f4ng th\u00edch h\u1ee3p h\u00f3a tr\u1ecb ph\u1ed1i h\u1ee3p v\u1edbi fludarabin.<\/p>\n<p><em>U lympho kh\u00f4ng Hodgkin:<\/em> U lympho kh\u00f4ng Hodgkin th\u1ec3 di\u1ec5n ti\u1ebfn ch\u1eadm \u1edf b\u1ec7nh nh\u00e2n b\u1ec7nh ti\u1ebfn tri\u1ec3n sau \u0111i\u1ec1u tr\u1ecb v\u1edbi rituximab ho\u1eb7c h\u00f3a tr\u1ecb ph\u1ed1i h\u1ee3p v\u1edbi rituximab.<\/p>\n<p><em>\u0110a u t\u1ee7y:<\/em> \u0110i\u1ec1u tr\u1ecb b\u01b0\u1edbc m\u1ed9t cho \u0111a u t\u1ee7y (ph\u00e2n lo\u1ea1i Durie-Salmon giai \u0111o\u1ea1n II c\u00f3 ti\u1ebfn tri\u1ec3n hay giai \u0111o\u1ea1n III) ph\u1ed1i h\u1ee3p v\u1edbi prednison \u1edf b\u1ec7nh nh\u00e2n tr\u00ean 65 tu\u1ed5i m\u00e0 kh\u00f4ng th\u00edch h\u1ee3p gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c t\u1ef1 th\u00e2n v\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd th\u1ea7n kinh tr\u00ean l\u00e2m s\u00e0ng v\u00e0o th\u1eddi \u0111i\u1ec3m ch\u1ea9n \u0111o\u00e1n m\u00e0 kh\u00f4ng th\u1ec3 s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb c\u00f3 bortezomib hay thalidomid.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"42-lieu-dung-%e2%80%93-cach-dung\"><\/span>4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><strong><em>C\u00e1ch d\u00f9ng<\/em><\/strong> :<\/p>\n<p>D\u00f9ng ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch trong 30-60 ph\u00fat.<\/p>\n<p>H\u01af\u1edaNG D\u1eaaN S\u1eec D\u1ee4NG V\u00c0 X\u1eec L\u00dd<\/p>\n<p>Khi chu\u1ea9n b\u1ecb RIBOMUSTIN, n\u00ean tr\u00e1nh h\u00edt v\u00e0o hay ti\u1ebfp x\u00fac v\u1edbi da v\u00e0 ni\u00eam m\u1ea1c (mang g\u0103ng tay v\u00e0 qu\u1ea7n \u00e1o b\u1ea3o h\u1ed9!). Ph\u1ea7n c\u01a1 th\u1ec3 b\u1ecb nhi\u1ec5m thu\u1ed1c n\u00ean \u0111\u01b0\u1ee3c r\u1eeda c\u1ea9n th\u1eadn b\u1eb1ng n\u01b0\u1edbc v\u00e0 x\u00e0 ph\u00f2ng, n\u00ean r\u1eeda m\u1eaft v\u1edbi n\u01b0\u1edbc mu\u1ed1i sinh l\u00fd. Khuy\u1ebfn c\u00e1o n\u1ebfu c\u00f3 th\u1ec3 n\u00ean pha ch\u1ebf tr\u00ean nh\u1eefng b\u00e0n l\u00e0m vi\u1ec7c an to\u00e0n \u0111\u1eb7c bi\u1ec7t kh\u00f4ng th\u1ea5m n\u01b0\u1edbc, n\u1ec1n h\u1ea5p thu ho\u00e0n to\u00e0n.<\/p>\n<p>Ph\u1ee5 n\u1eef c\u00f3 thai tr\u00e1nh kh\u00f4ng thao t\u00e1c x\u1eed l\u00fd c\u00e1c ch\u1ea5t k\u00ecm h\u00e3m t\u1ebf b\u00e0o.<\/p>\n<p>B\u1ed9t pha dung d\u1ecbch \u0111\u1eadm \u0111\u1eb7c \u0111\u1ec3 pha dung d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch ph\u1ea3i \u0111\u01b0\u1ee3c ho\u00e0n nguy\u00ean v\u1edbi n\u01b0\u1edbc pha ti\u00eam, pha lo\u00e3ng v\u1edbi dung d\u1ecbch pha ti\u00eam NaCl 9 mg\/mL (0,9%), sau \u0111\u00f3 s\u1eed d\u1ee5ng b\u1eb1ng c\u00e1ch truy\u1ec1n t\u0129nh m\u1ea1ch. N\u00ean s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt v\u00f4 tr\u00f9ng.<\/p>\n<p><em>Ho\u00e0n nguy\u00ean thu\u1ed1c<\/em><\/p>\n<p>Ho\u00e0n nguy\u00ean m\u1ed7i l\u1ecd RIBOMUSTIN ch\u1ee9a 25 mg bendamustin hydrochlorid trong 10 mL n\u01b0\u1edbc pha ti\u00eam v\u00e0 l\u1eafc.<\/p>\n<p>Ho\u00e0n nguy\u00ean m\u1ed7i l\u1ecd RIBOMUSTIN ch\u1ee9a 100 mg bendamustin hydrochlorid trong 40 mL n\u01b0\u1edbc pha ti\u00eam v\u00e0 l\u1eafc.<\/p>\n<p>M\u1ed7i mL dung d\u1ecbch \u0111\u00e3 ho\u00e0n nguy\u00ean ch\u1ee9a 2,5 mg bendamustin hydrochlorid v\u00e0 l\u00e0 dung d\u1ecbch kh\u00f4ng m\u00e0u, trong su\u1ed1t.<\/p>\n<p><em>Pha lo\u00e3ng<\/em><\/p>\n<p>Ngay khi thu \u0111\u01b0\u1ee3c dung d\u1ecbch trong su\u1ed1t (th\u01b0\u1eddng sau 5-10 ph\u00fat) pha lo\u00e3ng ngay to\u00e0n b\u1ed9 li\u1ec1u khuy\u1ebfn c\u00e1o c\u1ee7a RIBOMUSTIN v\u1edbi dung d\u1ecbch NaCl 0,9% \u0111\u1ec3 \u0111\u01b0\u1ee3c th\u1ec3 t\u00edch cu\u1ed1i c\u00f9ng kho\u1ea3ng 500 mL.<\/p>\n<p>RIBOMUSTIN ph\u1ea3i \u0111\u01b0\u1ee3c pha lo\u00e3ng v\u1edbi dung d\u1ecbch NaCl 0,9% v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e9p pha v\u1edbi b\u1ea5t k\u1ef3 dung d\u1ecbch ti\u00eam truy\u1ec1n n\u00e0o kh\u00e1c.<\/p>\n<p><em>C\u00e1ch d\u00f9ng<\/em><\/p>\n<p>Dung d\u1ecbch pha ch\u1ebf \u0111\u01b0\u1ee3c truy\u1ec1n t\u0129nh m\u1ea1ch trong 30-60 ph\u00fat.<\/p>\n<p>L\u1ecd thu\u1ed1c ch\u1ec9 s\u1eed d\u1ee5ng m\u1ed9t l\u1ea7n duy nh\u1ea5t.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p><em>B\u1ec7nh b\u1ea1ch c\u1ea7u lympho m\u1ea1n<\/em>: bendamustin hydrochlorid 100 mg\/m\u00b2 di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t c\u01a1 th\u1ec3, v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2 c\u1ee7a c\u00e1c chu k\u1ef3, m\u1ed7i chu k\u1ef3 4 tu\u1ea7n, t\u1ed1i \u0111a 6 chu k\u1ef3.<\/p>\n<p><em>U lympho kh\u00f4ng Hodgkin<\/em>: bendamustin hydrochlorid 120 mg\/m\u00b2 di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t c\u01a1 th\u1ec3, v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2 c\u1ee7a c\u00e1c chu k\u1ef3, m\u1ed7i chu k\u1ef3 3 tu\u1ea7n, trong \u00edt nh\u1ea5t 6 \u0111\u1ebfn 8 chu k\u1ef3 (t\u1ed1i \u0111a 8 chu k\u1ef3).<\/p>\n<p><em>\u0110a u t\u1ee7y<\/em>: bendamustin hydrochlorid 120-150 mg\/m\u00b2 di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t c\u01a1 th\u1ec3, v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2, ph\u1ed1i h\u1ee3p v\u1edbi prednison 60 mg\/m\u00b2 di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t c\u01a1 th\u1ec3 ti\u00eam t\u0129nh m\u1ea1ch hay u\u1ed1ng t\u1eeb ng\u00e0y 1 \u0111\u1ebfn ng\u00e0y 4 c\u1ee7a c\u00e1c chu k\u1ef3, m\u1ed7i chu k\u1ef3 4 tu\u1ea7n trong \u00edt nh\u1ea5t 3 chu k\u1ef3.<\/p>\n<p>N\u00ean tr\u00ec ho\u00e3n hay ng\u1eebng \u0111i\u1ec1u tr\u1ecb n\u1ebfu s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u gi\u1ea3m \u0111\u1ebfn 3.000\/\u03bcL v\u00e0\/ho\u1eb7c s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u gi\u1ea3m \u0111\u1ebfn &lt; 75.000\/\u03bcL. C\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb sau khi s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u t\u0103ng \u0111\u1ebfn &gt;4.000\/\u03bcL v\u00e0 s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u t\u0103ng \u0111\u1ebfn &gt;100.000\/\u03bcL.<\/p>\n<p>S\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u v\u00e0 ti\u1ec3u c\u1ea7u th\u1ea5p nh\u1ea5t \u0111o \u0111\u01b0\u1ee3c sau 14-20 ng\u00e0y, ph\u1ee5c h\u1ed3i sau 3-5 tu\u1ea7n.<\/p>\n<p>Khuy\u1ebfn c\u00e1o n\u00ean theo d\u00f5i ch\u1eb7t ch\u1ebd c\u00f4ng th\u1ee9c m\u00e1u trong kho\u1ea3ng th\u1eddi gian ngh\u1ec9 kh\u00f4ng \u0111i\u1ec1u tr\u1ecb .<\/p>\n<p>Trong tr\u01b0\u1eddng h\u1ee3p \u0111\u1ed9c t\u00ednh kh\u00f4ng thu\u1ed9c huy\u1ebft h\u1ecdc, vi\u1ec7c gi\u1ea3m li\u1ec1u ph\u1ea3i d\u1ef1a tr\u00ean m\u1ee9c \u0111\u1ed9 \u0111\u1ed9c t\u00ednh x\u1ea5u nh\u1ea5t theo Ti\u00eau chu\u1ea9n \u0111\u1ed9c t\u00ednh th\u01b0\u1eddng g\u1eb7p (CTC) c\u1ee7a chu k\u1ef3 tr\u01b0\u1edbc. Khuy\u1ebfn c\u00e1o gi\u1ea3m 50% li\u1ec1u d\u00f9ng trong tr\u01b0\u1eddng h\u1ee3p \u0111\u1ed9c t\u00ednh m\u1ee9c \u0111\u1ed9 3 theo CTC. Khuy\u1ebfn c\u00e1o ng\u1eebng \u0111i\u1ec1u tr\u1ecb trong tr\u01b0\u1eddng h\u1ee3p \u0111\u1ed9c t\u00ednh m\u1ee9c \u0111\u1ed9 4 theo CTC.<\/p>\n<p>N\u1ebfu c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u cho m\u1ed9t b\u1ec7nh nh\u00e2n th\u00ec li\u1ec1u \u0111\u00e3 gi\u1ea3m \u0111\u01b0\u1ee3c t\u00ednh ri\u00eang cho b\u1ec7nh nh\u00e2n \u0111\u00f3 ph\u1ea3i \u0111\u01b0\u1ee3c d\u00f9ng v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2 c\u1ee7a chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb t\u01b0\u01a1ng \u1ee9ng.<\/p>\n<p>Xem h\u01b0\u1edbng d\u1eabn chu\u1ea9n b\u1ecb v\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c trong m\u1ee5c &#8221;H\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng v\u00e0 x\u1eed l\u00fd&#8221;.<\/p>\n<p><em>Suy<\/em> <em>gan<\/em><\/p>\n<p>D\u1ef1a tr\u00ean d\u1eef li\u1ec7u d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc, kh\u00f4ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u \u1edf b\u1ec7nh nh\u00e2n suy gan nh\u1eb9 (bilirubin huy\u1ebft thanh &lt; 1,2 mg\/dL). Khuy\u1ebfn c\u00e1o gi\u1ea3m 30% li\u1ec1u d\u00f9ng \u1edf b\u1ec7nh nh\u00e2n suy gan trung b\u00ecnh (bilirubin huy\u1ebft thanh 1,2-3 mg\/dL).<\/p>\n<p>Kh\u00f4ng c\u00f3 s\u1eb5n d\u1eef li\u1ec7u \u1edf b\u1ec7nh nh\u00e2n suy gan n\u1eb7ng (bilirubin huy\u1ebft thanh &gt;3 mg\/dL) .<\/p>\n<p><em>Suy th\u1eadn:<\/em><\/p>\n<p>D\u1ef1a tr\u00ean d\u1eef li\u1ec7u d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc, kh\u00f4ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u \u1edf b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ed9 thanh th\u1ea3i creatinin &gt;10 mL\/ph\u00fat. Kinh nghi\u1ec7m \u1edf b\u1ec7nh nh\u00e2n suy th\u1eadn n\u1eb7ng c\u00f2n h\u1ea1n ch\u1ebf.<\/p>\n<p><em>B\u1ec7nh nh\u00e2n nhi<\/em>: T\u00ednh an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a bendamustin tr\u00ean b\u1ec7nh nh\u00e2n nhi ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c l\u1eadp do d\u1eef li\u1ec7u c\u00f2n h\u1ea1n ch\u1ebf.<\/p>\n<p><em>B\u1ec7nh nh\u00e2n cao tu\u1ed5i:<\/em> Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u \u1edf b\u1ec7nh nh\u00e2n cao tu\u1ed5i.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h3><span class=\"ez-toc-section\" id=\"43-chong-chi-dinh\"><\/span>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Qu\u00e1 m\u1eabn v\u1edbi ho\u1ea1t ch\u1ea5t ho\u1eb7c v\u1edbi b\u1ea5t k\u1ef3 t\u00e1 d\u01b0\u1ee3c n\u00e0o.<\/p>\n<p>\u0110ang cho con b\u00fa.<\/p>\n<p>Suy gan n\u1eb7ng (bilirubin huy\u1ebft thanh &gt;3 mg\/dL).<\/p>\n<p>V\u00e0ng da.<\/p>\n<p>Suy t\u1ee7y x\u01b0\u01a1ng n\u1eb7ng v\u00e0 thay \u0111\u1ed5i s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o m\u00e1u nghi\u00eam tr\u1ecdng (b\u1ea1ch c\u1ea7u gi\u1ea3m \u0111\u1ebfn &lt; 3.000\/\u03bcL v\u00e0\/ ho\u1eb7c ti\u1ec3u c\u1ea7u gi\u1ea3m \u0111\u1ebfn &lt; 75.000\/\u03bcL).<\/p>\n<p>Tr\u1ea3i qua \u0111\u1ea1i ph\u1eabu d\u01b0\u1edbi 30 ng\u00e0y tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>Nhi\u1ec5m tr\u00f9ng, \u0111\u1eb7c bi\u1ec7t \u0111i k\u00e8m gi\u1ea3m b\u1ea1ch c\u1ea7u.<\/p>\n<p>\u0110ang ch\u1ee7ng ng\u1eeba b\u1ec7nh s\u1ed1t v\u00e0ng.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"44-than-trong\"><\/span>4.4 Th\u1eadn tr\u1ecdng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>Suy t\u1ee7y<\/em><\/p>\n<p>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi bendamustin hydrochlorid c\u00f3 th\u1ec3 b\u1ecb suy t\u1ee7y (suy t\u1ee7y x\u01b0\u01a1ng).<\/p>\n<p>Khi c\u00f3 bi\u1ebfn c\u1ed1 suy t\u1ee7y do \u0111i\u1ec1u tr\u1ecb, n\u00ean theo d\u00f5i b\u1ea1ch c\u1ea7u, ti\u1ec3u c\u1ea7u, hemoglobin v\u00e0 b\u1ea1ch c\u1ea7u trung t\u00ednh v\u00e0 \u0111\u00e1nh gi\u00e1 l\u1ea1i tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb ti\u1ebfp theo. Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb ti\u1ebfp theo, khuy\u1ebfn c\u00e1o c\u1ea7n \u0111\u1ea1t \u0111\u01b0\u1ee3c c\u00e1c th\u00f4ng s\u1ed1 sau \u0111\u00e2y: s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u &gt;4.000\/\u03bcL v\u00e0\/ho\u1eb7c s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u &gt;100.000\/\u03bcL.<\/p>\n<p>Suy t\u1ee7y do \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u v\u00e0\/ho\u1eb7c tr\u00ec ho\u00e3n li\u1ec1u. Kh\u00f4ng n\u00ean d\u00f9ng Bendamustine khi b\u1ecb suy t\u1ee7y n\u1eb7ng ho\u1eb7c thay \u0111\u1ed5i s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o m\u00e1u nghi\u00eam tr\u1ecdng .<\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 t\u00e1i ho\u1ea1t \u0111\u1ed9ng c\u1ee7a Cytomegalovirus (CMV) v\u00e0 vir\u00fat Herpes.<\/p>\n<p><em>Nhi\u1ec5m tr\u00f9ng:<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 nhi\u1ec5m tr\u00f9ng, bao g\u1ed3m vi\u00eam ph\u1ed5i v\u00e0 nhi\u1ec5m khu\u1ea9n huy\u1ebft. Trong v\u00e0i tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm g\u1eb7p, nhi\u1ec5m tr\u00f9ng li\u00ean quan v\u1edbi t\u00ecnh tr\u1ea1ng c\u1ea7n ph\u1ea3i nh\u1eadp vi\u1ec7n, s\u1ed1c nhi\u1ec5m tr\u00f9ng v\u00e0 t\u1eed vong. B\u1ec7nh nh\u00e2n suy t\u1ee7y sau \u0111i\u1ec1u tr\u1ecb v\u1edbi bendamustin hydrochlorid th\u00ec d\u1ec5 b\u1ecb nhi\u1ec5m tr\u00f9ng. B\u1ec7nh nh\u00e2n b\u1ecb suy t\u1ee7y sau \u0111i\u1ec1u tr\u1ecb v\u1edbi Bendamustine \u0111\u01b0\u1ee3c khuy\u00ean li\u00ean h\u1ec7 v\u1edbi th\u1ea7y thu\u1ed1c n\u1ebfu c\u00f3 nh\u1eefng tri\u1ec7u ch\u1ee9ng hay d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng, bao g\u1ed3m s\u1ed1t hay tri\u1ec7u ch\u1ee9ng c\u1ee7a \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p.<\/p>\n<p><em>Ph\u1ea3n \u1ee9ng tr\u00ean da<\/em>:<\/p>\n<p>M\u1ed9t s\u1ed1 ph\u1ea3n \u1ee9ng tr\u00ean da \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. C\u00e1c bi\u1ebfn c\u1ed1 n\u00e0y bao g\u1ed3m ph\u00e1t ban, ph\u1ea3n \u1ee9ng \u0111\u1ed9c tr\u00ean da v\u00e0 ph\u00e1t ban da d\u1ea1ng b\u00f3ng n\u01b0\u1edbc. M\u1ed9t v\u00e0i bi\u1ebfn c\u1ed1 x\u1ea3y ra khi d\u00f9ng bendamustin k\u1ebft h\u1ee3p v\u1edbi c\u00e1c t\u00e1c nh\u00e2n ch\u1ed1ng ung th\u01b0 kh\u00e1c, do \u0111\u00f3 ch\u01b0a r\u00f5 m\u1ed1i li\u00ean h\u1ec7 ch\u00ednh x\u00e1c. Khi xu\u1ea5t hi\u1ec7n ph\u1ea3n \u1ee9ng tr\u00ean da, n\u1ebfu ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb th\u00ec c\u00e1c ph\u1ea3n \u1ee9ng n\u00e0y c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n v\u00e0 n\u1eb7ng l\u00ean; v\u00ec th\u1ebf c\u1ea7n theo d\u00f5i ch\u1eb7t ch\u1ebd c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 ph\u1ea3n \u1ee9ng da. N\u1ebfu ph\u1ea3n \u1ee9ng da nghi\u00eam tr\u1ecdng ho\u1eb7c ti\u1ebfn tri\u1ec3n, n\u00ean t\u1ea1m d\u1eebng hay ng\u1eebng \u0111i\u1ec1u tr\u1ecb Bendamustine. \u0110\u1ed1i v\u1edbi nh\u1eefng ph\u1ea3n \u1ee9ng tr\u00ean da nghi\u00eam tr\u1ecdng m\u00e0 nghi ng\u1edd c\u00f3 li\u00ean quan v\u1edbi bendamustin hydrochlorid th\u00ec n\u00ean ng\u1eebng \u0111i\u1ec1u tr\u1ecb. \u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ecb h\u1ed9i ch\u1ee9ng Stevens-Johnson v\u00e0 ho\u1ea1i t\u1eed bi\u1ec3u b\u00ec nhi\u1ec5m \u0111\u1ed9c (TEN), m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p t\u1eed vong, khi d\u00f9ng bendamustin \u0111\u1ed3ng th\u1eddi v\u1edbi allopurinol v\u00e0 c\u00e1c thu\u1ed1c kh\u00e1c \u0111\u01b0\u1ee3c bi\u1ebft g\u00e2y n\u00ean h\u1ed9i ch\u1ee9ng n\u00e0y.<\/p>\n<p><em>B\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c r\u1ed1i lo\u1ea1n tim<\/em><\/p>\n<p>N\u00ean theo d\u00f5i ch\u1eb7t ch\u1ebd n\u1ed3ng \u0111\u1ed9 kali m\u00e1u trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb v\u1edbi bendamustin hydrochlorid v\u00e0 n\u00ean b\u1ed5 sung kali khi K+ &lt; 3,5 mEq\/L v\u00e0 ph\u1ea3i \u0111o \u0111i\u1ec7n t\u00e2m \u0111\u1ed3.<\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p t\u1eed vong do nh\u1ed3i m\u00e1u c\u01a1 tim v\u00e0 suy tim khi \u0111i\u1ec1u tr\u1ecb v\u1edbi bendamustin. B\u1ec7nh nh\u00e2n \u0111ang b\u1ecb b\u1ec7nh tim ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh tim c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd.<\/p>\n<p><em>Bu\u1ed3n n\u00f4n, n\u00f4n:<\/em><\/p>\n<p>C\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c ch\u1ed1ng n\u00f4n \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c tri\u1ec7u ch\u1ee9ng bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n.<\/p>\n<p><em>H\u1ed9i ch\u1ee9ng ly gi\u1ea3i kh\u1ed1i u:<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 h\u1ed9i ch\u1ee9ng ly gi\u1ea3i kh\u1ed1i u li\u00ean quan \u0111\u1ebfn \u0111i\u1ec1u tr\u1ecb v\u1edbi Bendamustine \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n tham gia c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng. H\u1ed9i ch\u1ee9ng n\u00e0y c\u00f3 khuynh h\u01b0\u1edbngx\u1ea3y ra trong v\u00f2ng 48 gi\u1edd c\u1ee7a li\u1ec1u Bendamustine \u0111\u1ea7u ti\u00ean v\u00e0 n\u1ebfu kh\u00f4ng can thi\u1ec7p c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn suy th\u1eadn c\u1ea5p v\u00e0 t\u1eed vong. C\u00e1c bi\u1ec7n ph\u00e1p d\u1ef1 ph\u00f2ng bao g\u1ed3m t\u00ecnh tr\u1ea1ng d\u1ecbch \u0111\u1ea7y \u0111\u1ee7, theo d\u00f5i ch\u1eb7t ch\u1ebd sinh h\u00f3a m\u00e1u, \u0111\u1eb7c bi\u1ec7t l\u00e0 n\u1ed3ng \u0111\u1ed9 kali v\u00e0 acid uric. C\u00f3 th\u1ec3 c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng allopurinol trong 1 \u0111\u1ebfn 2 tu\u1ea7n \u0111\u1ea7u ti\u00ean \u0111i\u1ec1u tr\u1ecb v\u1edbi Bendamustine nh\u01b0ng kh\u00f4ng nh\u1ea5t thi\u1ebft l\u00e0 m\u1ed9t \u0111i\u1ec1u tr\u1ecb ti\u00eau chu\u1ea9n.<\/p>\n<p><em>S\u1ed1c ph\u1ea3n v\u1ec7:<\/em><\/p>\n<p>C\u00e1c ph\u1ea3n \u1ee9ng trong khi truy\u1ec1n \u0111\u1ed1i v\u1edbi bendamustin hydrochlorid th\u01b0\u1eddng x\u1ea3y ra \u1edf c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng. Nh\u00ecn chung c\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng nh\u1eb9 v\u00e0 bao g\u1ed3m s\u1ed1t, \u1edbn l\u1ea1nh, ng\u1ee9a v\u00e0 n\u1ed5i ban. Trong m\u1ed9t s\u1ed1 hi\u1ebfm tr\u01b0\u1eddng h\u1ee3p \u0111\u00e3 g\u1eb7p ph\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7 hay s\u1ed1c ph\u1ea3n v\u1ec7 n\u1eb7ng. Ph\u1ea3i h\u1ecfi b\u1ec7nh nh\u00e2n v\u1ec1 c\u00e1c tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd ph\u1ea3n \u1ee9ng do truy\u1ec1n sau chu k\u1ef3 \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u ti\u00ean. Ph\u1ea3i c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba c\u00e1c ph\u1ea3n \u1ee9ng n\u1eb7ng, bao g\u1ed3m s\u1eed d\u1ee5ng kh\u00e1ng histamin, h\u1ea1 s\u1ed1t v\u00e0 corticosteroid \u1edf nh\u1eefng chu k\u1ef3 ti\u1ebfp theo tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 x\u1ea3y ra ph\u1ea3n \u1ee9ng ti\u00eam truy\u1ec1n tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n<p>Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb ph\u1ea3n \u1ee9ng ki\u1ec3u d\u1ecb \u1ee9ng \u0111\u1ed9 3 ho\u1eb7c x\u1ea5u h\u01a1n l\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec3n h\u00ecnh kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u1ea1i thu\u1ed1c.<\/p>\n<p><em>Ng\u1eeba thai<\/em><\/p>\n<p>Bendamustin hydrochlorid l\u00e0 ch\u1ea5t g\u00e2y \u0111\u1ed9t bi\u1ebfn v\u00e0 qu\u00e1i thai.<\/p>\n<p>Ph\u1ee5 n\u1eef kh\u00f4ng n\u00ean c\u00f3 thai trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb. B\u1ec7nh nh\u00e2n nam kh\u00f4ng n\u00ean c\u00f3 con trong l\u00fac \u0111i\u1ec1u tr\u1ecb v\u00e0 \u0111\u1ebfn 6 th\u00e1ng sau \u0111i\u1ec1u tr\u1ecb. B\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u1ec1 vi\u1ec7c b\u1ea3o qu\u1ea3n tinh tr\u00f9ng tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb v\u1edbi Bendamustine b\u1edfi v\u00ec c\u00f3 kh\u1ea3 n\u0103ng b\u1ecb v\u00f4 sinh kh\u00f4ng h\u1ed3i ph\u1ee5c.<\/p>\n<p><em>Tho\u00e1t m\u1ea1ch:<\/em><\/p>\n<p>N\u00ean ng\u1eebng ngay l\u1eadp t\u1ee9c n\u1ebfu truy\u1ec1n thu\u1ed1c ra ngo\u00e0i m\u1ea1ch. N\u00ean l\u1ea5y kim ra sau khi \u0111\u00e3 h\u00fat ra m\u1ed9t \u00edt. Sau \u0111\u00f3 n\u00ean ch\u01b0\u1eddm l\u1ea1nh v\u00f9ng m\u00f4 b\u1ecb t\u1ed5n th\u01b0\u01a1ng v\u00e0 \u0111\u1ec3 cao c\u00e1nh tay. Ch\u01b0a th\u1ea5y l\u1ee3i \u00edch r\u00f5 r\u00e0ng v\u1edbi nh\u1eefng \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 nh\u01b0 s\u1eed d\u1ee5ng corticosteroid.<\/p>\n<p><em>B\u1ec7nh \u00e1c t\u00ednh kh\u00e1c:<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 c\u00e1c kh\u1ed1i u th\u1ee9 ph\u00e1t, bao g\u1ed3m h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n sinh t\u1ee7y, c\u00e1c r\u1ed1i lo\u1ea1n t\u0103ng sinh t\u1ee7y, b\u1ec7nh b\u1ea1ch c\u1ea7u c\u1ea5p d\u00f2ng t\u1ee7y v\u00e0 carcin\u00f4m ph\u1ebf qu\u1ea3n. Ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c m\u1ed1i li\u00ean quan v\u1edbi \u0111i\u1ec1u tr\u1ecb bendamustin.<\/p>\n<p><em>T\u00e1i ho\u1ea1t \u0111\u1ed9ng vi\u00eam gan B:<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 t\u00e1i ho\u1ea1t \u0111\u1ed9ng vi\u00eam gan B bao g\u1ed3m t\u1eed vong v\u00e0 c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n vi\u00eam gan do t\u00e1i ho\u1ea1t vi r\u00fat vi\u00eam gan B. N\u00ean \u00e1p d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p th\u00edch h\u1ee3p x\u00e1c \u0111\u1ecbnh b\u1ec7nh nh\u00e2n nhi\u1ec5m vi\u00eam gan B tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb v\u1edbi Bendamustine, n\u00ean theo d\u00f5i th\u01b0\u1eddng xuy\u00ean ch\u1ee9c n\u0103ng gan v\u00e0 c\u00e1c ch\u1ec9 d\u1ea5u (markers) vi\u00eam gan B, n\u00ean s\u1eed d\u1ee5ng thu\u1ed1c th\u00edch h\u1ee3p v\u00e0\/ho\u1eb7c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba \u0111\u1ec3 ng\u0103n ng\u1eeba t\u00e1i ho\u1ea1t vi r\u00fat vi\u00eam gan B.<\/p>\n<p><strong>T\u00e1c \u0111\u1ed9ng c\u1ee7a thu\u1ed1c tr\u00ean ng\u01b0\u1eddi l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/strong><\/p>\n<p>Ch\u01b0a ti\u1ebfn h\u00e0nh c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c tr\u00ean kh\u1ea3 n\u0103ng l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c. Tuy nhi\u00ean, m\u1ea5t \u0111i\u1ec1u h\u00f2a v\u1eadn \u0111\u1ed9ng, b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i vi v\u00e0 ng\u1ee7 g\u00e0 \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o khi \u0111i\u1ec1u tr\u1ecb v\u1edbi Bendamustine . N\u00ean h\u01b0\u1edbng d\u1eabn b\u1ec7nh nh\u00e2n tr\u00e1nh nh\u1eefng c\u00f4ng vi\u1ec7c mang t\u00ednh nguy hi\u1ec3m nh\u01b0 l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c n\u1ebfu h\u1ecd c\u00f3 nh\u1eefng tri\u1ec7u ch\u1ee9ng n\u00eau tr\u00ean.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"45-su-dung-cho-phu-nu-co-thai-va-cho-con-bu\"><\/span>4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>X\u1ebfp h\u1ea1ng c\u1ea3nh b\u00e1o<\/em><\/p>\n<p>AU TGA pregnancy category: D<\/p>\n<p>US FDA pregnancy category: D<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>Kh\u00f4ng \u0111\u1ee7 d\u1eef ki\u1ec7n v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng Bendamustine \u1edf ph\u1ee5 n\u1eef c\u00f3 thai. Tr\u00ean c\u00e1c nghi\u00ean c\u1ee9u ti\u1ec1n l\u00e2m s\u00e0ng, bendamustin l\u00e0 ch\u1ea5t g\u00e2y \u0111\u1ed9c ph\u00f4i\/thai, sinh qu\u00e1i thai v\u00e0 g\u00e2y \u0111\u1ed9c gen. Ph\u1ee5 n\u1eef c\u00f3 kh\u1ea3 n\u0103ng mang thai ph\u1ea3i d\u00f9ng c\u00e1c bi\u1ec7n ph\u00e1p tr\u00e1nh thai hi\u1ec7u qu\u1ea3 tr\u01b0\u1edbc, trong v\u00e0 m\u1ed9t th\u00e1ng sau khi \u0111i\u1ec1u tr\u1ecb v\u1edbi Bendamustine.<\/p>\n<p>Trong th\u1eddi gian mang thai, kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng Bendamustine tr\u1eeb khi l\u1ee3i \u00edch v\u01b0\u1ee3t tr\u1ed9i nguy c\u01a1. Ng\u01b0\u1eddi m\u1eb9 n\u00ean \u0111\u01b0\u1ee3c bi\u1ebft v\u1ec1 nguy c\u01a1 \u0111\u1ed1i v\u1edbi thai. N\u1ebfu \u0111i\u1ec1u tr\u1ecb Bendamustine l\u00e0 ho\u00e0n to\u00e0n c\u1ea7n thi\u1ebft trong l\u00fac \u0111ang mang thai hay n\u1ebfu c\u00f3 thai trong khi \u0111ang \u0111i\u1ec1u tr\u1ecb, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c bi\u1ebft v\u1ec1 nguy c\u01a1 cho \u0111\u1ee9a tr\u1ebb ch\u01b0a sinh v\u00e0 n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i c\u1ea9n th\u1eadn. N\u00ean xem x\u00e9t kh\u1ea3 n\u0103ng t\u01b0 v\u1ea5n v\u1ec1 di truy\u1ec1n.<\/p>\n<p><em>Kh\u1ea3 n\u0103ng sinh s\u1ea3n:<\/em><\/p>\n<p>Nam gi\u1edbi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi bendamustin n\u00ean \u0111\u01b0\u1ee3c khuy\u00ean kh\u00f4ng c\u00f3 con trong khi \u0111i\u1ec1u tr\u1ecb v\u00e0 6 th\u00e1ng sau khi k\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb. N\u00ean t\u01b0 v\u1ea5n b\u1ea3o qu\u1ea3n tinh tr\u00f9ng tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb b\u1edfi v\u00ec c\u00f3 th\u1ec3 x\u1ea3y ra v\u00f4 sinh kh\u00f4ng ph\u1ee5c h\u1ed3i khi \u0111i\u1ec1u tr\u1ecb v\u1edbi Bendamustine.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Ch\u01b0a r\u00f5 bendamustin c\u00f3 \u0111i qua s\u1eefa m\u1eb9 hay kh\u00f4ng, v\u00ec th\u1ebf ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh Bendamustine khi \u0111ang cho con b\u00fa . Ph\u1ea3i ng\u1eebng cho con b\u00fa trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb v\u1edbi Bendamustine.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h3><span class=\"ez-toc-section\" id=\"46-tac-dung-khong-mong-muon-adr\"><\/span>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>C\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i th\u01b0\u1eddng g\u1eb7p nh\u1ea5t khi s\u1eed d\u1ee5ng bendamustin hydrochlorid l\u00e0 ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i v\u1ec1 huy\u1ebft h\u1ecdc (gi\u1ea3m b\u1ea1ch c\u1ea7u, gi\u1ea3m ti\u1ec3u c\u1ea7u), \u0111\u1ed9c t\u00ednh tr\u00ean da (ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng), tri\u1ec7u ch\u1ee9ng to\u00e0n th\u00e2n (s\u1ed1t), tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1eddng ti\u00eau h\u00f3a (bu\u1ed3n n\u00f4n, n\u00f4n).<\/p>\n<p>B\u1ea3ng 1 cung c\u1ea5p d\u1eef li\u1ec7u thu \u0111\u01b0\u1ee3c t\u1eeb c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng v\u1edbi bendamustin hydrochlorid.<\/p>\n<table>\n<tbody>\n<tr>\n<td><strong>Ph\u00e2n lo\u1ea1i h\u1ec7 th\u1ed1ng c\u01a1 quan theo MedDRA<\/strong><\/td>\n<td><strong>R\u1ea5t th\u01b0\u1eddng g\u1eb7p (&gt;1\/10)<\/strong><\/td>\n<td><strong>Th\u01b0\u1eddng g\u1eb7p (&gt;1\/100 -&lt;1 \/10)<\/strong><\/td>\n<td><strong>\u00edt g\u1eb7p (&gt;1\/1000-&lt;1\/100)<\/strong><\/td>\n<td><strong>Hi\u1ebfm g\u1eb7p (&gt;1\/10000-&lt;1\/1000)<\/strong><\/td>\n<td><strong>R\u1ea5t hi\u1ebfm g\u1eb7p (&lt;1\/10000)<\/strong><\/td>\n<td><strong>Kh\u00f4ng bi\u1ebft (kh\u00f4ng th\u1ec3 \u01b0\u1edbc t\u00ednh t\u1eeb d\u1eef li\u1ec7u c\u00f3 s\u1eb5n)<\/strong><\/td>\n<\/tr>\n<tr>\n<td><strong>Nhi\u1ec5m tr\u00f9ng v\u00e0 nhi\u1ec5m k\u1ef7 sinh tr\u00f9ng<\/strong><\/td>\n<td>Nhi\u1ec5m tr\u00f9ng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u<\/td>\n<td><\/td>\n<td><\/td>\n<td>Nhi\u1ec5m tr\u00f9ng huy\u1ebft<\/td>\n<td>Vi\u00eam ph\u1ed5i nguy\u00ean ph\u00e1t kh\u00f4ng \u0111i\u1ec3n h\u00ecnh<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>U l\u00e0nh, u \u00e1c<\/strong><\/td>\n<td><\/td>\n<td>H\u1ed9i ch\u1ee9ng ly gi\u1ea3i kh\u1ed1i u<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n m\u00e1u v\u00e0 h\u1ec7 b\u1ea1ch huy\u1ebft<\/strong><\/td>\n<td>Gi\u1ea3m b\u1ea1ch c\u1ea7u kh\u00f4ng \u0111\u1eb7c hi\u1ec7u, Gi\u1ea3m ti\u1ec3u c\u1ea7u<\/td>\n<td>Xu\u1ea5t huy\u1ebft, Thi\u1ebfu m\u00e1u, Gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh<\/td>\n<td><\/td>\n<td><\/td>\n<td>T\u00e1n huy\u1ebft<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n h\u1ec7 mi\u1ec5n d\u1ecbch<\/strong><\/td>\n<td><\/td>\n<td>Qu\u00e1 m\u1eabn kh\u00f4ng \u0111\u1eb7c hi\u1ec7u<\/td>\n<td><\/td>\n<td>Ph\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7, Ph\u1ea3n \u1ee9ng d\u1ea1ng ph\u1ea3n v\u1ec7<\/td>\n<td>S\u1ed1c ph\u1ea3n v\u1ec7<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n h\u1ec7 th\u1ea7n kinh<\/strong><\/td>\n<td><\/td>\n<td>M\u1ea5t ng\u1ee7<\/td>\n<td><\/td>\n<td>Ng\u1ee7 g\u00e0, M\u1ea5t ti\u1ebfng<\/td>\n<td>Lo\u1ea1n v\u1ecb gi\u00e1c, Lo\u1ea1n c\u1ea3m gi\u00e1c, B\u1ec7nh th\u1ea7n kinh c\u1ea3m gi\u00e1c ngo\u1ea1i vi, H\u1ed9i ch\u1ee9ng kh\u00e1ng ti\u1ebft cholin, R\u1ed1i lo\u1ea1n th\u1ea7n kinh, M\u1ea5t \u0111i\u1ec1u h\u00f2a v\u1eadn \u0111\u1ed9ng, Vi\u00eam n\u00e3o<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n tim<\/strong><\/td>\n<td><\/td>\n<td>R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng tim, nh\u01b0 \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, \u0111au th\u1eaft ng\u1ef1c, Rung nh\u0129<\/td>\n<td>Tr\u00e0n d\u1ecbch m\u00e0ng tim<\/td>\n<td><\/td>\n<td>Nh\u1ecbp tim nhanh, Nh\u1ed3i m\u00e1u c\u01a1 tim, Suy tim<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n m\u1ea1ch m\u00e1u<\/strong><\/td>\n<td><\/td>\n<td>H\u1ea1 huy\u1ebft \u00e1p<\/td>\n<td><\/td>\n<td>Suy tu\u1ea7n ho\u00e0n c\u1ea5p<\/td>\n<td>Vi\u00eam t\u0129nh m\u1ea1ch<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n h\u00f4 h\u1ea5p, l\u1ed3ng ng\u1ef1c v\u00e0 trung th\u1ea5t<\/strong><\/td>\n<td><\/td>\n<td>R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng ph\u1ed5i<\/td>\n<td><\/td>\n<td><\/td>\n<td>X\u01a1 ph\u1ed5i<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a<\/strong><\/td>\n<td>Bu\u1ed3n n\u00f4n, n\u00f4n<\/td>\n<td>Ti\u00eau ch\u1ea3y, T\u00e1o b\u00f3n, Vi\u00eam mi\u1ec7ng<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>Vi\u00eam th\u1ef1c qu\u1ea3n xu\u1ea5t huy\u1ebft, Xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a<\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n da v\u00e0 m\u00f4 d\u01b0\u1edbi da<\/strong><\/td>\n<td><\/td>\n<td>R\u1ee5ng t\u00f3c, C\u00e1c r\u1ed1i lo\u1ea1n da kh\u00f4ng \u0111\u1eb7c hi\u1ec7u<\/td>\n<td><\/td>\n<td>Ban \u0111\u1ecf, Vi\u00eam da, Ng\u1ee9a, Ban s\u1ea7n-d\u00e1t, T\u0103ng ti\u1ebft m\u1ed3 h\u00f4i<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n h\u1ec7 sinh s\u1ea3n v\u00e0 v\u00fa<\/strong><\/td>\n<td><\/td>\n<td>V\u00f4 kinh<\/td>\n<td><\/td>\n<td><\/td>\n<td>V\u00f4 sinh<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>R\u1ed1i lo\u1ea1n to\u00e0n th\u00e2n v\u00e0 t\u00ecnh tr\u1ea1ng n\u01a1i truy\u1ec1n<\/strong><\/td>\n<td>Vi\u00eam ni\u00eam m\u1ea1c, M\u1ec7t m\u1ecfi, S\u1ed1t<\/td>\n<td>\u0110au, \u1edbn l\u1ea1nh, M\u1ea5t n\u01b0\u1edbc, Ch\u00e1n \u0103n<\/td>\n<td><\/td>\n<td><\/td>\n<td>Suy \u0111a c\u01a1 quan<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td><strong>C\u00e1c th\u00f4ng s\u1ed1 x\u00e9t nghi\u1ec7m<\/strong><\/td>\n<td>Gi\u1ea3m haemoglobin, T\u0103ng Creatinin, T\u0103ng ur\u00ea<\/td>\n<td>T\u0103ng AST, T\u0103ng ALT, T\u0103ng alkalin phosphatase, T\u0103ng bilirubin, Gi\u1ea3m kali m\u00e1u<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>M\u1ed9t s\u1ed1 \u00edt tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t hi\u1ec7n h\u1ed9i ch\u1ee9ng Stevens-Johnson v\u00e0 ho\u1ea1i t\u1eed bi\u1ec3u b\u00ec nhi\u1ec5m \u0111\u1ed9c \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf b\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng bendamustin k\u1ebft h\u1ee3p v\u1edbi allopurinol hay k\u1ebft h\u1ee3p v\u1edbi allopurinol v\u00e0 rituximab. Ngo\u00e0i ra, m\u1ed9t v\u00e0i tr\u01b0\u1eddng h\u1ee3p t\u00e1i ho\u1ea1t vi\u00eam gan B d\u1eabn \u0111\u1ebfn suy gan \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf c\u00e1c b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u1edbi bendamustin. Gi\u1ea3m t\u1ebf b\u00e0o m\u00e1u, \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u1edbi bendamustin.<\/p>\n<p>T\u1ec9 l\u1ec7 CD4\/CD8 c\u00f3 th\u1ec3 gi\u1ea3m. C\u0169ng g\u1eb7p gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o lympho. \u1ede b\u1ec7nh nh\u00e2n suy gi\u1ea3m mi\u1ec5n d\u1ecbch, c\u00f3 th\u1ec3 t\u0103ng nguy c\u01a1 nhi\u1ec5m tr\u00f9ng (v\u00ed d\u1ee5 Herpes zoster).<\/p>\n<p>\u0110\u00e3 c\u00f3 nh\u1eefng b\u00e1o c\u00e1o ri\u00eang l\u1ebb v\u1ec1 ho\u1ea1i t\u1eed sau khi v\u00f4 t\u00ecnh truy\u1ec1n thu\u1ed1c ra ngo\u00e0i m\u1ea1ch m\u00e1u v\u00e0 ho\u1ea1i t\u1eed bi\u1ec3u b\u00ec nhi\u1ec5m \u0111\u1ed9c, h\u1ed9i ch\u1ee9ng ly gi\u1ea3i kh\u1ed1i u v\u00e0 s\u1ed1c ph\u1ea3n v\u1ec7.<\/p>\n<p>C\u00f3 c\u00e1c b\u00e1o c\u00e1o v\u1ec1 kh\u1ed1i u th\u1ee9 ph\u00e1t bao g\u1ed3m h\u1ed9i ch\u1ee9ng lo\u1ea1n s\u1ea3n t\u1ee7y, r\u1ed1i lo\u1ea1n t\u0103ng sinh t\u1ee7y, b\u1ec7nh b\u1ea1ch c\u1ea7u t\u1ee7y c\u1ea5p v\u00e0 carcin\u00f4m ph\u1ebf qu\u1ea3n. Tuy nhi\u00ean, m\u1ed1i li\u00ean quan v\u1edbi \u0111i\u1ec1u tr\u1ecb Bendamustine v\u1eabn ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c.<\/p>\n<p><em> Th\u00f4ng b\u00e1o cho B\u00e1c s\u0129 nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n g\u1eb7p ph\u1ea3i khi s\u1eed d\u1ee5ng thu\u1ed1c.<\/em><\/p>\n<h3><span class=\"ez-toc-section\" id=\"47-huong-dan-cach-xu-tri-adr\"><\/span>4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c. V\u1edbi c\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i nh\u1eb9, th\u01b0\u1eddng ch\u1ec9 c\u1ea7n ng\u1eebng thu\u1ed1c. Tr\u01b0\u1eddng h\u1ee3p m\u1eabn c\u1ea3m n\u1eb7ng ho\u1eb7c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, c\u1ea7n ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 (gi\u1eef tho\u00e1ng kh\u00ed v\u00e0 d\u00f9ng epinephrin, th\u1edf oxygen, d\u00f9ng kh\u00e1ng histamin, corticoid&#8230;).<\/p>\n<h3><span class=\"ez-toc-section\" id=\"48-tuong-tac-voi-cac-thuoc-khac\"><\/span>4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Kh\u00f4ng c\u00f3 nghi\u00ean c\u1ee9u t\u01b0\u01a1ng t\u00e1c thu\u1ed1c in-vivo.<\/p>\n<p>Khi k\u1ebft h\u1ee3p RIBOMUSTIN v\u1edbi c\u00e1c thu\u1ed1c g\u00e2y \u1ee9c ch\u1ebf t\u1ee7y, c\u00f3 th\u1ec3 c\u00f3 kh\u1ea3 n\u0103ng \u1ea3nh h\u01b0\u1edfng tr\u00ean t\u1ee7y x\u01b0\u01a1ng do RIBOMUSTIN v\u00e0\/ho\u1eb7c c\u00e1c thu\u1ed1c s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi. B\u1ea5t k\u1ef3 \u0111i\u1ec1u tr\u1ecb n\u00e0o l\u00e0m gi\u1ea3m th\u1ec3 tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n hay suy gi\u1ea3m ch\u1ee9c n\u0103ng t\u1ee7y x\u01b0\u01a1ng c\u0169ng c\u00f3 th\u1ec3 gia t\u0103ng \u0111\u1ed9c t\u00ednh c\u1ee7a RIBOMUSTIN.<\/p>\n<p>K\u1ebft h\u1ee3p RIBOMUSTIN v\u1edbi cyclosporin hay tacrolimus c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch qu\u00e1 m\u1ee9c v\u1edbi nguy c\u01a1 l\u00e0m t\u0103ng sinh d\u00f2ng lympho.<\/p>\n<p>K\u00ecm h\u00e3m ph\u00e2n b\u00e0o c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m s\u1ef1 t\u1ea1o th\u00e0nh kh\u00e1ng th\u1ec3 sau ch\u1ee7ng ng\u1eeba vi r\u00fat s\u1ed1ng gi\u1ea3m \u0111\u1ed9c l\u1ef1c v\u00e0 l\u00e0m t\u0103ng nguy c\u01a1 nhi\u1ec5m tr\u00f9ng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn k\u1ebft c\u1ee5c t\u1eed vong. Nguy c\u01a1 n\u00e0y t\u0103ng l\u00ean \u1edf nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u00e3 b\u1ecb \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch b\u1edfi b\u1ec7nh l\u00fd n\u1ec1n c\u1ee7a h\u1ecd.<\/p>\n<p>S\u1ef1 chuy\u1ec3n h\u00f3a bendamustin li\u00ean quan \u0111\u1ebfn enzym c\u00f3 c\u00f9ng ch\u1ee9c n\u0103ng cytochrom P450 (CYP) 1A2 (xem D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc). V\u00ec th\u1ebf, c\u00f3 kh\u1ea3 n\u0103ng x\u1ea3y ra t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1cch\u1ea5t \u1ee9c ch\u1ebf CYP1A2 (nh\u01b0 fluvoxamin, ciprofloxacin, acyclovir, cimetidin).<\/p>\n<h3><span class=\"ez-toc-section\" id=\"49-qua-lieu-va-xu-tri\"><\/span>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Sau khi truy\u1ec1n bendamustin trong 30 ph\u00fat m\u1ed9t l\u1ea7n m\u1ed7i 3 tu\u1ea7n, li\u1ec1u dung n\u1ea1p t\u1ed1i \u0111a l\u00e0 280 mg\/m\u00b2. Bi\u1ebfn c\u1ed1 tr\u00ean tim \u0111\u1ed9 2 theo CTC t\u01b0\u01a1ng \u1ee9ng v\u1edbi thay \u0111\u1ed5i ECG bi\u1ec3u hi\u1ec7n thi\u1ebfu m\u00e1u c\u01a1 tim \u0111\u01b0\u1ee3c xem l\u00e0 \u0111\u1ebfn gi\u1edbi h\u1ea1n li\u1ec1u.<\/p>\n<p>Trong m\u1ed9t nghi\u00ean c\u1ee9u ti\u1ebfp theo v\u1edbi bendamustin truy\u1ec1n trong 30 ph\u00fat v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2 m\u1ed7i 3 tu\u1ea7n, li\u1ec1u dung n\u1ea1p t\u1ed1i \u0111a c\u1ee7a thu\u1ed1c l\u00e0 180 mg\/m\u00b2. \u0110\u1ed9c t\u00ednh gi\u1edbi h\u1ea1n li\u1ec1u l\u00e0 gi\u1ea3m ti\u1ec3u c\u1ea7u \u0111\u1ed9 4. \u0110\u1ed9c t\u00ednh tr\u00ean tim th\u00ec kh\u00f4ng gi\u1edbi h\u1ea1n li\u1ec1u theo l\u1ecbch tr\u00ecnh n\u00e0y.<\/p>\n<p><em>Bi\u1ec7n ph\u00e1p x\u1eed tr\u00ed: <\/em>Kh\u00f4ng c\u00f3 ch\u1ea5t \u0111\u1ed1i kh\u00e1ng \u0111\u1eb7c hi\u1ec7u. C\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n gh\u00e9p t\u1ee7y x\u01b0\u01a1ng v\u00e0 truy\u1ec1n c\u00e1c ch\u1ebf ph\u1ea9m m\u00e1u (ti\u1ec3u c\u1ea7u, h\u1ed3ng c\u1ea7u l\u1eafng) ho\u1eb7c s\u1eed d\u1ee5ng c\u00e1c y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng t\u1ea1o huy\u1ebft nh\u01b0 l\u00e0 nh\u1eefng bi\u1ec7n ph\u00e1p x\u1eed tr\u00ed hi\u1ec7u qu\u1ea3 \u0111\u1ec3 ki\u1ec3m so\u00e1t t\u00e1c d\u1ee5ng ph\u1ee5 v\u1ec1 huy\u1ebft h\u1ecdc. Bendamustin hydrochlorid v\u00e0 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a b\u1ecb th\u1ea9m t\u00e1ch v\u1edbi m\u1ee9c \u0111\u1ed9 nh\u1ecf.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h2><span class=\"ez-toc-section\" id=\"5-co-che-tac-dung-cua-thuoc\"><\/span><strong>5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"51-duoc-luc-hoc\"><\/span>5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Nh\u00f3m d\u01b0\u1ee3c l\u00fd \u0111i\u1ec1u tr\u1ecb: thu\u1ed1c ch\u1ed1ng ung th\u01b0, nh\u00f3m alkyl, m\u00e3 ATC: L01AA09<\/p>\n<p>Bendamustin l\u00e0 thu\u1ed1c nh\u00f3m alkyl ch\u1ed1ng kh\u1ed1i u v\u1edbi ho\u1ea1t t\u00ednh \u0111\u1ed9c \u0111\u00e1o \u1edf ch\u1ed7 c\u00f3 ch\u1ee9a v\u00f2ng benzimidazol gi\u1ed1ng purin. T\u00e1c \u0111\u1ed9ng ch\u1ed1ng ung th\u01b0 v\u00e0 g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o c\u1ee7a bendamustin ch\u1ee7 y\u1ebfu d\u1ef1a tr\u00ean g\u1eafn k\u1ebft ch\u00e9o c\u1ee7a c\u00e1c s\u1ee3i DNA \u0111\u01a1n v\u00e0 k\u00e9p b\u1eb1ng alkyl h\u00f3a. K\u1ebft qu\u1ea3 l\u00e0 ch\u1ee9c n\u0103ng nh\u00e2n \u0111\u00f4i c\u1ee7a DNA, t\u1ed5ng h\u1ee3p v\u00e0 s\u1eeda ch\u1eefa DNA b\u1ecb h\u1ecfng. Bendamustin c\u00f3 ho\u1ea1t t\u00ednh ch\u1ed1ng l\u1ea1i c\u1ea3 hai lo\u1ea1i t\u1ebf b\u00e0o: t\u1ebf b\u00e0o \u0111ang ph\u00e2n chia v\u00e0 t\u1ebf b\u00e0o kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng.<\/p>\n<p>C\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng ch\u00ednh x\u00e1c c\u1ee7a bendamustin v\u1eabn c\u00f2n ch\u01b0a r\u00f5.<\/p>\n<p>T\u00e1c d\u1ee5ng ch\u1ed1ng kh\u1ed1i u c\u1ee7a bendamustin hydrochlorid \u0111\u01b0\u1ee3c ch\u1ee9ng minh trong m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u in-vitro tr\u00ean nhi\u1ec1u d\u00f2ng t\u1ebf b\u00e0o kh\u1ed1i u kh\u00e1c nhau \u1edf ng\u01b0\u1eddi (ung th\u01b0 v\u00fa, ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf v\u00e0 kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf, carcin\u00f4m bu\u1ed3ng tr\u1ee9ng v\u00e0 c\u00e1c b\u1ec7nh b\u1ea1ch c\u1ea7u kh\u00e1c nhau) v\u00e0 in-vivo tr\u00ean nhi\u1ec1u ki\u1ec3u kh\u1ed1i u th\u1ef1c nghi\u1ec7m kh\u00e1c nhau c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb chu\u1ed9t nh\u1eaft, chu\u1ed9t c\u1ed1ng v\u00e0 ng\u01b0\u1eddi (ung th\u01b0 h\u1eafc t\u1ed1, ung th\u01b0 v\u00fa, ung th\u01b0 m\u00f4 m\u1ec1m, u lympho, b\u1ec7nh b\u1ea1ch c\u1ea7u v\u00e0 ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf).<\/p>\n<p>Bendamustin hydrochlorid cho th\u1ea5y ho\u1ea1t t\u00ednh tr\u00ean nh\u1eefng d\u00f2ng t\u1ebf b\u00e0o kh\u1ed1i u \u1edf ng\u01b0\u1eddi kh\u00e1c v\u1edbi nh\u1eefng thu\u1ed1c nh\u00f3m alkyl kh\u00e1c. Ho\u1ea1t ch\u1ea5t c\u1ee7a thu\u1ed1c cho th\u1ea5y kh\u00f4ng c\u00f3 hay c\u00f3 r\u1ea5t \u00edt \u0111\u1ec1 kh\u00e1ng ch\u00e9o v\u1edbi c\u00e1c d\u00f2ng t\u1ebf b\u00e0o kh\u1ed1i u \u1edf ng\u01b0\u1eddi v\u1edbi c\u00e1c c\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng kh\u00e1c nhau \u00edt nh\u1ea5t m\u1ed9t ph\u1ea7n do s\u1ef1 t\u01b0\u01a1ng t\u00e1c v\u1edbi DNA t\u01b0\u01a1ng \u0111\u1ed1i b\u1ec1n v\u1eefng. H\u01a1n n\u1eefa, c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng cho th\u1ea5y kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1ng ch\u00e9o ho\u00e0n to\u00e0n c\u1ee7a bendamustin v\u1edbi anthracyclin, c\u00e1c thu\u1ed1c nh\u00f3m alkyl hay rituximab. Tuy nhi\u00ean, s\u1ed1 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 c\u00f2n \u00edt.<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Bendamustine l\u00e0 d\u1eabn xu\u1ea5t mechlorethamine 2 ch\u1ee9c n\u0103ng trong \u0111\u00f3 c\u00f3 kh\u1ea3 n\u0103ng t\u1ea1o th\u00e0nh c\u00e1c nh\u00f3m alkyl \u00e1i \u0111i\u1ec7n t\u1eed li\u00ean k\u1ebft c\u1ed9ng h\u00f3a tr\u1ecb v\u1edbi c\u00e1c ph\u00e2n t\u1eed kh\u00e1c. Ch\u1ee9c n\u0103ng n\u00e0y gi\u00fap Bendamustine nh\u01b0 m\u1ed9t t\u00e1c nh\u00e2n alkyl h\u00f3a, bendamustine g\u00e2y ra c\u00e1c li\u00ean k\u1ebft ch\u00e9o c\u1ee7a c\u00e1c s\u1ee3i DNA \u0111\u01a1n v\u00e0 k\u00e9p b\u1eb1ng alkyl h\u00f3a d\u1eabn \u0111\u1ebfn ch\u1ebft t\u1ebf b\u00e0o. N\u00f3 c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng l\u1ea1i c\u1ea3 t\u1ebf b\u00e0o \u0111ang ph\u00e2n chia v\u00e0 t\u1ebf b\u00e0o kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng, c\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng ch\u00ednh x\u00e1c hi\u1ec7n v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft.<\/p>\n<p><strong>[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/p>\n<h3><span class=\"ez-toc-section\" id=\"52-duoc-dong-hoc\"><\/span>5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>Ph\u00e2n b\u1ed1<\/em><\/p>\n<p>Th\u1eddi gian b\u00e1n th\u1ea3i t<sub>1\/2\u00df<\/sub>\u00a0sau 30 ph\u00fat truy\u1ec1n t\u0129nh m\u1ea1ch 120 mg\/m<sup>2<\/sup>\u00a0di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t cho 12 \u0111\u1ed1i t\u01b0\u1ee3ng th\u1eed nghi\u1ec7m l\u00e0 28,2 ph\u00fat. Sau khi truy\u1ec1n t\u0129nh m\u1ea1ch 30 ph\u00fat, th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 \u1edf trung t\u00e2m l\u00e0 19,3 L. Trong \u0111i\u1ec1u ki\u1ec7n \u1ed5n \u0111\u1ecbnh sau khi ti\u00eam t\u0129nh m\u1ea1ch nhanh, th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 l\u00e0 15,8-20,5 L.<br \/>\nTr\u00ean 95% ho\u1ea1t ch\u1ea5t \u0111\u01b0\u1ee3c g\u1eafn k\u1ebft v\u1edbi c\u00e1c protein huy\u1ebft t\u01b0\u01a1ng (ch\u1ee7 y\u1ebfu l\u00e0 albumin).<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a<\/em><\/p>\n<p>\u0110\u01b0\u1eddng th\u1ea3i tr\u1eeb ch\u00ednh c\u1ee7a bendamustin l\u00e0 th\u1ee7y ph\u00e2n th\u00e0nh monohydroxy- v\u00e0 dihydroxybendamustin. S\u1ef1 t\u1ea1o th\u00e0nh N-desmethyl-bendamustin v\u00e0 gamma-hydroxy-bendamustinqua chuy\u1ec3n h\u00f3a \u1edf gan nh\u1edd isoenzym cytochrom P450 (CYP) 1A2. \u0110\u01b0\u1eddng chuy\u1ec3n h\u00f3a ch\u00ednh kh\u00e1c c\u1ee7a bendamustin nh\u1edd g\u1eafn k\u1ebft v\u1edbi glutathion. <em>In-vitro<\/em>, bendamustin kh\u00f4ng \u1ee9c ch\u1ebf CYP 1A2, CYP 2C9\/10, CYP 2D6, CYP 2E1 v\u00e0 CYP 3A4.<\/p>\n<p><em>Th\u1ea3i tr\u1eeb:<\/em><\/p>\n<p>\u0110\u1ed9 thanh th\u1ea3i to\u00e0n b\u1ed9 trung b\u00ecnh sau truy\u1ec1n t\u0129nh m\u1ea1ch 30 ph\u00fat v\u1edbi li\u1ec1u 120 mg\/m<sup>2<\/sup>\u00a0di\u1ec7n t\u00edch b\u1ec1 m\u1eb7t c\u01a1 th\u1ec3 cho 12 \u0111\u1ed1i t\u01b0\u1ee3ng th\u1eed nghi\u1ec7m l\u00e0 639,4 mL\/ph\u00fat. Kho\u1ea3ng 20% li\u1ec1u s\u1eed d\u1ee5ng t\u00ecm th\u1ea5y trong n\u01b0\u1edbc ti\u1ec3u 24 gi\u1edd. L\u01b0\u1ee3ng b\u00e0i ti\u1ebft trong n\u01b0\u1edbc ti\u1ec3u theo th\u1ee9 t\u1ef1 l\u00e0: monohydroxy-bendamustin &gt; bendamustin &gt; dihydroxy-bendamustin &gt; ch\u1ea5t chuy\u1ec3n h\u00f3a oxy h\u00f3a &gt; N-desmethyl bendamustin. Trong m\u1eadt, c\u00e1c s\u1ea3n ph\u1ea9m chuy\u1ec3n h\u00f3a ch\u00ednh c\u00f3 t\u00ednh ph\u00e2n c\u1ef1c b\u1ecb th\u1ea3i tr\u1eeb.<\/p>\n<p><em>Suy gan:<\/em><\/p>\n<p>\u0110\u1eb7c t\u00ednh d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc kh\u00f4ng thay \u0111\u1ed5i \u1edf c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 30-70% gan b\u1ecb ph\u00e1 h\u1ee7y do kh\u1ed1i u v\u00e0 suy gan nh\u1eb9 (bilirubin huy\u1ebft thanh &lt; 1,2 mg\/dL). Kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a gi\u1eefa b\u1ec7nh nh\u00e2n n\u00e0y v\u1edbi b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ee9c n\u0103ng gan v\u00e0 th\u1eadn b\u00ecnh th\u01b0\u1eddng v\u1ec1 C<sub>max<\/sub>, t<sub>max<\/sub>, AUC, t<sub>1\/2\u03b2<\/sub>, th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 v\u00e0 \u0111\u1ed9 thanh th\u1ea3i. AUC v\u00e0 \u0111\u1ed9 thanh th\u1ea3i to\u00e0n b\u1ed9 tr\u00ean c\u01a1 th\u1ec3 c\u1ee7a bendamustin t\u1ec9 l\u1ec7 ngh\u1ecbch v\u1edbi bilirubin huy\u1ebft thanh.<\/p>\n<p><em>Suy th\u1eadn:<\/em><\/p>\n<p>\u1ede c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ed9 thanh th\u1ea3i creatinin &gt; 10 mL\/ph\u00fat, k\u1ec3 c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n ph\u1ea3i l\u1ecdc m\u00e1u, kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a so v\u1edbi b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ee9c n\u0103ng gan v\u00e0 th\u1eadn b\u00ecnh th\u01b0\u1eddng x\u00e9t v\u1ec1 C<sub>max<\/sub>, t<sub>max<\/sub>, AUC, t<sub>1\/2\u03b2<\/sub>, th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 v\u00e0 thanh th\u1ea3i.<\/p>\n<p><em>B\u1ec7nh nh\u00e2n cao tu\u1ed5i:<\/em>\u00a0B\u1ec7nh nh\u00e2n \u0111\u1ebfn 84 tu\u1ed5i c\u0169ng \u0111\u01b0\u1ee3c bao g\u1ed3m trong c\u00e1c nghi\u00ean c\u1ee9u d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc. Tu\u1ed5i cao kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a bendamustin.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h3><span class=\"ez-toc-section\" id=\"53-hieu-qua-lam-sang\"><\/span>5.3. Hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>B\u1ec7nh b\u1ea1ch c\u1ea7u lympho m\u1ea1n (Chronic Lymphocytic Leukemia &#8211; CLL)<\/em><\/p>\n<p>Ch\u1ec9 \u0111\u1ecbnh d\u00f9ng cho CLL \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 b\u1edfi m\u1ed9t nghi\u00ean c\u1ee9u nh\u00e3n m\u1edf, \u0111\u01a1n l\u1ebb so s\u00e1nh bendamustin v\u00e0 chlorambucil. M\u1ed9t nghi\u00ean c\u1ee9u \u0111a trung t\u00e2m, ng\u1eabu nhi\u00ean, ti\u1ec1n c\u1ee9u baog\u1ed3m 319 b\u1ec7nh nh\u00e2n CLL ch\u01b0a \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc \u0111\u00f3, giai \u0111o\u1ea1n B hay C theo Binet v\u00e0 c\u00f3 ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb. \u0110i\u1ec1u tr\u1ecb b\u01b0\u1edbc m\u1ed9t v\u1edbi bendamustin hydrochlorid 100 mg\/m\u00b2 truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2 (BEN) \u0111\u01b0\u1ee3c so s\u00e1nh v\u1edbi chlorambucil 0,8 mg\/kg v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 15 (CLB) trong 6 chu k\u1ef3 cho c\u1ea3 hai nh\u00f3m. B\u1ec7nh nh\u00e2n d\u00f9ng allopurinol v\u1edbi m\u1ee5c \u0111\u00edch ph\u00f2ng ng\u1eeba h\u1ed9i ch\u1ee9ng ly gi\u1ea3i kh\u1ed1i u.<\/p>\n<p>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb BEN c\u00f3 trung v\u1ecb s\u1ed1ng c\u00f2n kh\u00f4ng tri\u1ebfn tri\u1ec3n b\u1ec7nh d\u00e0i h\u01a1n m\u1ed9t c\u00e1ch c\u00f3 \u00fd ngh\u0129a so v\u1edbi \u0111i\u1ec1u tr\u1ecb CLB (21,5 th\u00e1ng so v\u1edbi 8,3 th\u00e1ng, p&lt;0,0001 trong theo d\u00f5i g\u1ea7n nh\u1ea5t). S\u1ed1ng c\u00f2n to\u00e0n b\u1ed9 kh\u00f4ng kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea (trung v\u1ecb kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c). Trung v\u1ecb th\u1eddi gian \u0111\u00e1p \u1ee9ng l\u00e0 19 th\u00e1ng v\u1edbi BEN so v\u1edbi 6 th\u00e1ng v\u1edbi CLB (p&lt;0,0001). \u0110\u00e1nh gi\u00e1 t\u00ednh an to\u00e0n tr\u00ean c\u1ea3 hai nh\u00f3m \u0111i\u1ec1u tr\u1ecb kh\u00f4ng th\u1ea5y b\u1ea5t k\u1ef3 ph\u1ea3n \u1ee9ng b\u1ea5tl\u1ee3i n\u00e0o x\u00e9t v\u1ec1 b\u1ea3n ch\u1ea5t v\u00e0 v\u1ec1 t\u1ea7n su\u1ea5t. 34% b\u1ec7nh nh\u00e2n v\u1edbi BEN \u0111\u01b0\u1ee3c gi\u1ea3m li\u1ec1u. Ng\u1eebng \u0111i\u1ec1u tr\u1ecb v\u1edbi BEN \u1edf 3,9% b\u1ec7nh nh\u00e2n do ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng.<\/p>\n<p><em>U lympho kh\u00f4ng Hodgkin di\u1ec5n ti\u1ebfn ch\u1eadm (Indolent Non-Hodgkin\u2019s LymphomaiNHL)<\/em><\/p>\n<p>Ch\u1ec9 \u0111\u1ecbnh cho u lympho kh\u00f4ng Hodgkin di\u1ec5n ti\u1ebfn ch\u1eadm (iNHL) d\u1ef1a tr\u00ean hai th\u1eed nghi\u1ec7m pha II kh\u00f4ng c\u00f3 \u0111\u1ed1i ch\u1ee9ng.<\/p>\n<p>Trong m\u1ed9t nghi\u00ean c\u1ee9u m\u1ea5u ch\u1ed1t, ti\u1ec1n c\u1ee9u, \u0111a trung t\u00e2m, nh\u00e3n m\u1edf, tr\u00ean 100 b\u1ec7nh nh\u00e2n iNHL t\u1ebf b\u00e0o B kh\u00e1ng tr\u1ecb v\u1edbi rituximab \u0111\u01a1n tr\u1ecb ho\u1eb7c ph\u1ed1i h\u1ee3p \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01a1n tr\u1ecb li\u1ec7u v\u1edbi BEN. B\u1ec7nh nh\u00e2n \u0111\u00e3 nh\u1eadn trung v\u1ecb 3 \u0111\u1ee3t h\u00f3a tr\u1ecb hay thu\u1ed1c sinh h\u1ecdc tr\u01b0\u1edbc \u0111\u00f3. Trung v\u1ecb s\u1ed1 \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb c\u00f3 rituximab tr\u01b0\u1edbc \u0111\u00f3 l\u00e0 2. B\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng hay ti\u1ebfn tri\u1ec3n b\u1ec7nh trong v\u00f2ng 6 th\u00e1ng sau \u0111i\u1ec1u tr\u1ecb rituximab. Li\u1ec1u c\u1ee7a BEN l\u00e0 120 mg\/m\u00b2 truy\u1ec1n t\u0129nh m\u1ea1ch,v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2 trong t\u1ed1i thi\u1ec3u 6 chu k\u1ef3. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u00e1p \u1ee9ng (k\u1ebf ho\u1ea1ch l\u00e0 6 chu k\u1ef3). T\u1ec9 l\u1ec7 \u0111\u00e1p \u1ee9ng to\u00e0n b\u1ed9 l\u00e0 75% bao g\u1ed3m 17% \u0111\u00e1p \u1ee9ng ho\u00e0n to\u00e0n (\u0111\u00e1p \u1ee9ng ho\u00e0n to\u00e0n v\u00e0 \u0111\u00e1p \u1ee9ng ho\u00e0n to\u00e0n kh\u00f4ng x\u00e1c \u0111\u1ecbnh) v\u00e0 58% \u0111\u00e1p \u1ee9ng m\u1ed9t ph\u1ea7n, \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1edfi m\u1ed9t \u1ee7y ban xem x\u00e9t \u0111\u1ed9c l\u1eadp. Trung v\u1ecb th\u1eddi gian \u0111\u00e1p \u1ee9ng l\u00e0 40 tu\u1ea7n. Nh\u00ecn chung BEN \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t khi s\u1eed d\u1ee5ng theo li\u1ec1u v\u00e0 l\u1ecbch tr\u00ecnh n\u00e0y.<\/p>\n<p>Ch\u1ec9 \u0111\u1ecbnh n\u00e0y c\u00f2n \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 h\u01a1n n\u1eefa b\u1edfi m\u1ed9t nghi\u00ean c\u1ee9u m\u1edf, \u0111a trung t\u00e2m, ti\u1ec1n c\u1ee9u kh\u00e1c tr\u00ean 77 b\u1ec7nh nh\u00e2n. D\u00e2n s\u1ed1 b\u1ec7nh nh\u00e2n \u0111a d\u1ea1ng h\u01a1n bao g\u1ed3m: U lympho kh\u00f4ng Hodgkin (NHL \u2013 non-Hodgkin Lymphoma) t\u1ebf b\u00e0o B di\u1ec5n ti\u1ebfn ch\u1eadm ho\u1eb7c b\u1ecb bi\u1ebfn \u0111\u1ed5i kh\u00e1ng rituximab \u0111\u01a1n tr\u1ecb hay ph\u1ed1i h\u1ee3p. B\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng hay ti\u1ebfn tri\u1ec3n b\u1ec7nh trong v\u00f2ng 6 th\u00e1ng hay c\u00f3 ph\u1ea3n \u1ee9ng kh\u00f4ng thu\u1eadn l\u1ee3i v\u1edbi \u0111i\u1ec1u tr\u1ecb rituximab tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n<p>B\u1ec7nh nh\u00e2n \u0111\u00e3 nh\u1eadn trung v\u1ecb 3 \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc \u0111\u00f3 b\u1eb1ng h\u00f3a tr\u1ecb hay b\u1eb1ng sinh h\u1ecdc. Trung v\u1ecb s\u1ed1 \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc \u0111\u00f3 c\u00f3 rituximab l\u00e0 2. T\u1ec9 l\u1ec7 \u0111\u00e1p \u1ee9ng to\u00e0n b\u1ed9 l\u00e0 76% v\u1edbi trung v\u1ecb th\u1eddi gian \u0111\u00e1p \u1ee9ng l\u00e0 5 th\u00e1ng (29 tu\u1ea7n [kho\u1ea3ng tin c\u1eady 95%: 22,1; 43,1]).<\/p>\n<p>Bendamustin k\u1ebft h\u1ee3p v\u1edbi rituximab (BR) \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u trong m\u1ed9t th\u1eed nghi\u1ec7m c\u00f3 t\u1ef1a \u0111\u1ec1 \u201cM\u1ed9t nghi\u00ean c\u1ee9u \u0111a trung t\u00e2m pha II \u0111\u1ec3 kh\u1ea3o s\u00e1t t\u00ednh an to\u00e0n v\u00e0 t\u00e1c d\u1ee5ng c\u1ee7a SDX-105 (Bendamustin) khi k\u1ebft h\u1ee3p v\u1edbi Rituximab \u1edf b\u1ec7nh nh\u00e2n NHL th\u1ec3 di\u1ec5n ti\u1ebfn ch\u1eadm hay t\u1ebf b\u00e0o mantle t\u00e1i ph\u00e1t\u201d. B\u1ec7nh nh\u00e2n d\u00f9ng m\u1ed9t li\u1ec1u rituximab 375 mg\/m2 v\u00e0o th\u1eddi \u0111i\u1ec3m 7 ng\u00e0y tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u chu k\u1ef3 28 ng\u00e0y \u0111\u1ea7u ti\u00ean c\u1ee7a bendamustin v\u00e0 rituximab. Ti\u1ebfp theo, d\u00f9ng rituximab li\u1ec1u \u0111\u01a1n 375 mg\/m2 v\u00e0o ng\u00e0y \u0111\u1ea7u ti\u00ean c\u1ee7a 1 chu k\u1ef3, sau \u0111\u00f3 d\u00f9ng bendamustin v\u1edbi li\u1ec1u 90 mg\/m2\/ng\u00e0y v\u00e0o ng\u00e0y th\u1ee9 hai v\u00e0 th\u1ee9 ba c\u1ee7a chu k\u1ef3. K\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb l\u00e0 4 chu k\u1ef3 28 ng\u00e0y. C\u00f3 67 b\u1ec7nh nh\u00e2n tham gia v\u00e0o th\u1eed nghi\u1ec7m v\u00e0 66 tr\u01b0\u1eddng h\u1ee3p nh\u1eadn \u00edt nh\u1ea5t m\u1ed9t li\u1ec1u bendamustin v\u00e0 rituximab (BR). K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u n\u00e0y cho th\u1ea5y \u0111i\u1ec1u tr\u1ecb ph\u1ed1i h\u1ee3p bendamustin v\u00e0 rituximab hi\u1ec7u qu\u1ea3 \u1edf b\u1ec7nh nh\u00e2n NHL th\u1ec3 di\u1ec5n ti\u1ebfn ch\u1eadm hay NHL t\u1ebf b\u00e0o mantle t\u00e1i ph\u00e1t v\u1edbi t\u1ec9 l\u1ec7 \u0111\u00e1p \u1ee9ng to\u00e0n b\u1ed9 92% v\u00e0 \u0111\u00e1p \u1ee9ng ho\u00e0n to\u00e0n 41%. \u0110\u00e1p \u1ee9ng \u0111\u1ea1t \u0111\u01b0\u1ee3c b\u1ec1n v\u1eefng v\u1edbi trung v\u1ecb th\u1eddi gian \u0111\u00e1p \u1ee9ng l\u00e0 91 tu\u1ea7n v\u00e0 trung v\u1ecb s\u1ed1ng c\u00f2n kh\u00f4ng ti\u1ebfn tri\u1ec3n b\u1ec7nh 100 tu\u1ea7n. M\u1ed9t t\u1ec9 l\u1ec7 cao \u0111\u00e1p \u1ee9ng b\u1ec1n v\u1eefng \u0111\u01b0\u1ee3c quan s\u00e1t th\u1ea5y \u1edf c\u1ea3 hai nh\u00f3m b\u1ec7nh nh\u00e2n: nh\u00f3m \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc \u0111\u00f3 v\u1edbi rituximab v\u00e0 nh\u00f3m kh\u00e1ng tr\u1ecb alkyl g\u1ea7n \u0111\u00e2y nh\u1ea5t.<\/p>\n<p><em>\u0110a u t\u1ee7y<\/em><\/p>\n<p>M\u1ed9t nghi\u00ean c\u1ee9u m\u1edf, ng\u1eabu nhi\u00ean, \u0111a trung t\u00e2m, ti\u1ec1n c\u1ee9u g\u1ed3m 131 b\u1ec7nh nh\u00e2n \u0111a u t\u1ee7y ti\u1ebfn xa (giai \u0111o\u1ea1n II ti\u1ebfn tri\u1ec3n hay giai \u0111o\u1ea1n III theo ph\u00e2n lo\u1ea1i Durie-Salmon). \u0110i\u1ec1u tr\u1ecb b\u01b0\u1edbc m\u1ed9t v\u1edbi bendamustin hydrochlorid ph\u1ed1i h\u1ee3p v\u1edbi prednison (BP) \u0111\u01b0\u1ee3c so s\u00e1nh v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng melphalan v\u00e0 prednison (MP). \u0110\u1ed1i t\u01b0\u1ee3ng \u0111\u01b0a v\u00e0o th\u1eed nghi\u1ec7m kh\u00f4ng \u0111\u1ee7 ti\u00eau chu\u1ea9n \u0111\u1ec3 gh\u00e9p t\u1ee7y c\u0169ng kh\u00f4ng c\u00f3 b\u1ec7nh l\u00fd \u0111\u1eb7c bi\u1ec7t \u0111i k\u00e8m. Li\u1ec1u bendamustin hydrochlorid 150 mg\/m\u00b2 truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0o ng\u00e0y 1 v\u00e0 ng\u00e0y 2 ho\u1eb7c melphalan 15 mg\/m\u00b2 ti\u00eam t\u0129nh m\u1ea1ch v\u00e0o ng\u00e0y 1, v\u00e0 \u0111\u1ec1u \u0111\u01b0\u1ee3c ph\u1ed1i h\u1ee3p v\u1edbi prednison. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb; trung b\u00ecnh 6,8 chu k\u1ef3 \u1edf nh\u00f3m BP v\u00e0 8,7 chu k\u1ef3 \u1edf nh\u00f3m MP.<\/p>\n<p>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi BP c\u00f3 trung v\u1ecb s\u1ed1ng c\u00f2n kh\u00f4ng ti\u1ebfn tri\u1ec3n d\u00e0i h\u01a1n so v\u1edbi MP (15 th\u00e1ng [kho\u1ea3ng tin c\u1eady 95% 12-21] so v\u1edbi 12 th\u00e1ng [kho\u1ea3ng tin c\u1eady 95% 10-14] (p=0,0566). Trung v\u1ecb th\u1eddi gian th\u1ea5t b\u1ea1i \u0111i\u1ec1u tr\u1ecb l\u00e0 14 th\u00e1ng \u1edf nh\u00f3m BP v\u00e0 9 th\u00e1ng \u1edf nh\u00f3m MP. Th\u1eddi gian lui b\u1ec7nh l\u00e0 18 th\u00e1ng \u1edf nh\u00f3m BP v\u00e0 12 th\u00e1ng \u1edf nh\u00f3m MP. S\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 s\u1ed1ng c\u00f2n to\u00e0n b\u1ed9 kh\u00f4ng c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea (35 th\u00e1ng \u1edf nh\u00f3m BP so v\u1edbi 33 th\u00e1ng \u1edf nh\u00f3m MP). T\u00ednh dung n\u1ea1p \u1edf c\u1ea3 hai nh\u00f3m \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u1edbi d\u1eef li\u1ec7u v\u1ec1 t\u00ednh an to\u00e0n \u0111\u00e3 \u0111\u01b0\u1ee3c bi\u1ebft c\u1ee7a c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u01b0\u01a1ng \u1ee9ng v\u1edbi s\u1ef1 gi\u1ea3m li\u1ec1u thu\u1ed1c nhi\u1ec1u h\u01a1n \u0111\u00e1ng k\u1ec3 \u1edf nh\u00f3m BP.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"54-du-lieu-tien-lam-sang\"><\/span>5.4. D\u1eef li\u1ec7u ti\u1ec1n l\u00e2m s\u00e0ng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>C\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i kh\u00f4ng quan s\u00e1t th\u1ea5y tr\u00ean c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng, nh\u01b0ng \u0111\u00e3 g\u1eb7p \u1edf \u0111\u1ed9ng v\u1eadt v\u1edbi m\u1ee9c ph\u01a1i nhi\u1ec5m t\u01b0\u01a1ng t\u1ef1 nh\u01b0 m\u1ee9c ph\u01a1i nhi\u1ec5m tr\u00ean l\u00e2m s\u00e0ng v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng li\u00ean quan \u0111\u1ebfn vi\u1ec7c s\u1eed d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng nh\u01b0 sau:<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u m\u00f4 h\u1ecdc \u1edf ch\u00f3 cho th\u1ea5y xung huy\u1ebft \u0111\u1ea1i th\u1ec3 nh\u00ecn th\u1ea5y \u0111\u01b0\u1ee3c \u1edf ni\u00eam m\u1ea1c v\u00e0 xu\u1ea5t huy\u1ebft \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Nghi\u00ean c\u1ee9u vi th\u1ec3 qua k\u00ednh hi\u1ec3n vi cho th\u1ea5y nh\u1eefng thay \u0111\u1ed5i r\u1ed9ng c\u1ee7a m\u00f4 b\u1ea1ch huy\u1ebft th\u1ec3 hi\u1ec7n s\u1ef1 \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch v\u00e0 c\u00e1c thay \u0111\u1ed5i c\u1ee7a \u1ed1ng th\u1eadn v\u00e0 tinh ho\u00e0n, c\u0169ng nh\u01b0 c\u00e1c thay \u0111\u1ed5i ho\u1ea1i t\u1eed, teo nh\u1ecf c\u1ee7a bi\u1ec3u m\u00f4 ti\u1ec1n li\u1ec7t tuy\u1ebfn.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u \u1edf \u0111\u1ed9ng v\u1eadt cho th\u1ea5y bendamustin l\u00e0 t\u00e1c nh\u00e2n g\u00e2y \u0111\u1ed9c thai v\u00e0 qu\u00e1i thai.<\/p>\n<p>Bendamustin g\u00e2y ra s\u1ef1 kh\u00e1c th\u01b0\u1eddng c\u1ee7a nhi\u1ec5m s\u1eafc th\u1ec3 v\u00e0 l\u00e0 t\u00e1c nh\u00e2n g\u00e2y \u0111\u1ed9t bi\u1ebfn gen invivo c\u0169ng nh\u01b0 in-vitro. Trong nghi\u00ean c\u1ee9u d\u00e0i h\u1ea1n \u1edf chu\u1ed9t c\u00e1i, bendamustin l\u00e0 t\u00e1c nh\u00e2n sinh ung th\u01b0.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong><em>*L\u01b0u \u00fd:<\/em><\/strong><\/p>\n<p><strong><em>C\u00e1c th\u00f4ng tin v\u1ec1 thu\u1ed1c tr\u00ean Pharmog.com ch\u1ec9 mang t\u00ednh ch\u1ea5t tham kh\u1ea3o &#8211; Khi d\u00f9ng thu\u1ed1c c\u1ea7n tuy\u1ec7t \u0111\u1ed1i tu\u00e2n theo theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u00e1c s\u0129 <\/em><\/strong><\/p>\n<p><strong><em>Ch\u00fang t\u00f4i kh\u00f4ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m v\u1ec1 b\u1ea5t c\u1ee9 h\u1eadu qu\u1ea3 n\u00e0o x\u1ea3y ra do t\u1ef1 \u00fd d\u00f9ng thu\u1ed1c d\u1ef1a theo c\u00e1c th\u00f4ng tin tr\u00ean Pharmog.com<\/em><\/strong><\/p>\n<h2><span class=\"ez-toc-section\" id=\"6-phan-thong-tin-kem-theo-cua-thuoc\"><\/span><strong>6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"61-danh-muc-ta-duoc\"><\/span>6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>T\u00e1 d\u01b0\u1ee3c: Mannitol.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"62-tuong-ky\"><\/span>6.2. T\u01b0\u01a1ng k\u1ef5 :<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Kh\u00f4ng n\u00ean tr\u1ed9n thu\u1ed1c n\u00e0y v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c ngo\u1ea1i tr\u1eeb nh\u1eefng thu\u1ed1c \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp trong ph\u1ea7n &#8221;H\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng v\u00e0 x\u1eed l\u00fd&#8221;.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"63-bao-quan\"><\/span>6.3. B\u1ea3o qu\u1ea3n:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Gi\u1eef thu\u1ed1c trong h\u1ed9p \u0111\u1ec3 tr\u00e1nh \u00e1nh s\u00e1ng.<\/p>\n<p>B\u1ea3o qu\u1ea3n \u1edf nhi\u1ec7t \u0111\u1ed9 d\u01b0\u1edbi 30\u00b0C.<\/p>\n<p>B\u1ed9t \u0111\u00f4ng kh\u00f4 n\u00ean \u0111\u01b0\u1ee3c ho\u00e0n nguy\u00ean ngay sau khi m\u1edf l\u1ecd thu\u1ed1c.<\/p>\n<p>Thu\u1ed1c ho\u00e0n nguy\u00ean c\u1ea7n \u0111\u01b0\u1ee3c pha lo\u00e3ng ngay v\u1edbi dung d\u1ecbch NaCl 0,9%.<\/p>\n<p><em>Dung d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch<\/em><\/p>\n<p>Sau khi ho\u00e0n nguy\u00ean v\u00e0 pha lo\u00e3ng, thu\u1ed1c \u1ed5n \u0111\u1ecbnh v\u1ec1 h\u00f3a h\u1ecdc v\u00e0 v\u1eadt l\u00fd trong 3,5 gi\u1edd \u1edf 25\u00baC\/ 60% RH v\u00e0 trong 2 ng\u00e0y \u1edf 2\u00baC \u0111\u1ebfn 8\u00baC trong t\u00fai b\u1eb1ng polyethylen.<\/p>\n<p>T\u1eeb quan \u0111i\u1ec3m v\u1ec1 vi sinh h\u1ecdc, dung d\u1ecbch n\u00e0y n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ngay t\u1ee9c th\u00ec.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"64-thong-tin-khac\"><\/span>6.4. Th\u00f4ng tin kh\u00e1c :<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>M\u00f4 t\u1ea3: Bendamustin hydrochlorid d\u1ea1ng b\u1ed9t vi tinh th\u1ec3, m\u00e0u tr\u1eafng \u0111\u1ec3 ho\u00e0n nguy\u00ean v\u00e0 pha lo\u00e3ng th\u00e0nh dung d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"65-tai-lieu-tham-khao\"><\/span>6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>HDSD Thu\u1ed1c Ribomustin do C\u00f4ng ty Oncotec Pharma Produktion GmbH s\u1ea3n xu\u1ea5t (2018).<\/p>\n<p><a href=\"https:\/\/www.mims.com\/vietnam\/\">Mims Vi\u1ec7t Nam 2024<\/a>.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"7-nguoi-dang-tai-tac-gia\"><\/span><strong>7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c s\u01b0u t\u1ea7m ho\u1eb7c vi\u1ebft b\u1edfi: <a href=\"https:\/\/pharmog.com\/wp\/thong-tin-tac-gia-bac-sy-do-my-linh\/\">B\u00e1c s\u0129 nhi khoa &#8211; \u0110\u1ed7 M\u1ef9 Linh.<\/a><\/p>\n<p>Ki\u1ec3m duy\u1ec7t , hi\u1ec7u \u0111\u00ednh v\u00e0 \u0111\u0103ng t\u1ea3i: <a href=\"https:\/\/pharmog.com\/wp\/thong-tin-ve-pharmog-team\/\">PHARMOG TEAM<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ribomustin l\u00e0 thu\u1ed1c ph\u00e1t minh hay c\u00f2n g\u1ecdi l\u00e0 bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c do h\u00e3ng Janssen &#8211; Cilag Ltd \u0111\u0103ng k\u00fd. Thu\u1ed1c c\u00f3 ch\u1ee9a th\u00e0nh ph\u1ea7n ch\u00ednh l\u00e0 Bendamustine thu\u1ed9c nh\u00f3m thu\u1ed1c ung th\u01b0, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh b\u1ea1ch c\u1ea7u lympho m\u1ea1n t\u00ednh, u lympho kh\u00f4ng Hodgkin v\u00e0 b\u1ec7nh \u0111a u t\u1ee7y.<\/p>\n","protected":false},"author":8612,"featured_media":60536,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[370],"tags":[473],"class_list":["post-13753","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biet-duoc-goc","tag-bendamustine"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/13753","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/users\/8612"}],"replies":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/comments?post=13753"}],"version-history":[{"count":7,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/13753\/revisions"}],"predecessor-version":[{"id":60541,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/13753\/revisions\/60541"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/60536"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=13753"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=13753"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=13753"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}