Objetivo: El objetivo principal de este trabajo es identificar, mediante revisión bibliográfica sistemática, los estudios sobre  interacciones farmacológicas en pacientes sometidos a trasplante de  progenitores hematopoyéticos. Los objetivos secundarios son describir la  prevalencia de dichas interacciones y extraer información de interacciones  fármaco-fármaco concretas.

Método: Búsquedas en PubMed con los términos “drug-drug interaction”, “drug interaction”, “stem cell transplant”, “transplantation  conditioning” y “conditioning regimen” y en Embase “drug interaction”,  “stem cell transplantation” y “transplantation conditioning”, seleccionando  aquellos resultados relacionados directamente con el objetivo de la  revisión. Se priorizaron estudios en humanos, en idiomas inglés y español, entre enero de 2000 y noviembre de 2020.

Resultados: La revisión identificó dos grupos de estudios  epidemiológicos y de análisis de interacciones entre fármacos concretos).  Los 10 estudios epidemiológicos mostraron una prevalencia de  interacciones entre el 60% y el 100%, la base de datos más utilizada fue  Micromedex®, el mecanismo farmacocinético y los fármacos más  implicados fueron los antifúngicos azólicos, con resultados muy  heterogéneos. Los 52 estudios de interacciones entre fármacos fueron casi todos farmacocinéticos y se centraron fundamentalmente en las  interacciones de antifúngicos azólicos e inhibidores de la calcineurina. Algunos estudios describieron la posible relación entre interacciones y  reacciones adversas concretas o muertes por efectos adversos.

Conclusiones: La prevalencia de interacciones en pacientes sometidos a  trasplante de progenitores hematopoyéticos es elevada, siendo los  esultados heterogéneos, tanto en prevalencia como en el perfil de las  interacciones. En ello repercuten las diferencias en los diseños de los  estudios y en las bases de datos utilizadas. Entre los factores relacionados  con el riesgo de que se produzcan interacciones farmacológicas destaca el  elevado número de fármacos administrados. Los estudios que evalúan las  interacciones fármaco-fármaco son casi todos farmacocinéticos y se  centran mayoritariamente en antifúngicos azólicos e inhibidores de la  calcineurina. Sería importante unificar los criterios de los estudios  epidemiológicos para obtener resultados que ayuden a establecer  estrategias de reducción de riesgo, investigar en mayor profundidad las  interacciones de mecanismo farmacodinámico, las interacciones entre  otros fármacos de uso frecuente en el trasplante y en aquellos de  introducción reciente en el arsenal terapéutico.

Adelstein KE, Anderson JG, Taylor AG. Importance of meaning- making for patients undergoing hematopoietic stem cell transplantation. Oncol Nurs Forum. 2014;41(2):E172-84. DOI: 10.1188/14.ONF.E172-E184

Rifón JJ. Trasplante de progenitores hematopoyéticos. En: An Sist Sanit Navar [Internet]. 2006 [accessed 04/01/2020]; p. 29. Available at: http://scielo.isciii.es/scielo.php? script=sci_arttext&pid=S1137-66272006000400013&lng=en&nrm=iso&tlng=en

Galgano L, Hutt D. HSCT: How does it work? En: Kenyon M, Babic A, editores. The European Blood and Marrow Transplantation Textbook for Nurses [Internet]. Cham: Springer International Publishing; 2018 [accessed 04/01/2020]. p. 23-36. Available at: http://link.springer.com/10.1007/978-3-319-50026-3_2

Amariles P, Andrés Giraldo N, José Faus M. Interacciones medicamentosas:aproximación para establecer y evaluar su relevancia clínica. Med Clínica. 2007;129(1):27-35. DOI: 10.1157/13106681

Pejčić A, Janković SM, Opančina V, Babić G, Milosavljević M. Drug–drug interactions in patients receiving hematopoietic stem cell transplantation. Expert Opin Drug Metab Toxicol. 2019;15(1):49-59. DOI: 10.1080/17425255.2019.1552256

Cool RM, Gulbis AM. Rhabdomyolysis after concomitant use of simvastatin and voriconazole in an allogeneic stem cell transplant patient. J Pharm Technol [Internet]. 2013 [accessed 02/01/2020]. Available at: https://journals.sagepub.com/doi/10.1177/875512251302900306

Vives S, Batlle M, Montané E, Ribera JM. Rabdomiólisis e insuficiencia renal aguda secundaria a la interacción de simvastatina, ciclosporina A y risperidona en un paciente receptor de un trasplante alogénico de progenitores hematopoyéticos. Med Clínica. 2008;131(17):676. DOI: 10.1157/13128732

Yang T, Wu XM, Qiu HQ, Fu DH, Hu JD, Li J, et al. Adverse drug interactions as a high-risk factor for lethal post-transplant complications in Chinese population. Clin Transplant. 2013;27(2):255-60. DOI: 10.1111/ctr.12070

Valverde IA, da Silva MJ, Retto MP. Association between potential drug interactions and clinical outcomes in hematopoietic stem cell transplantations. J Oncol Pharm Pract. 2019;25(5):1105-11. DOI: 10.1177/1078155218775195

Glotzbecker B, Duncan C, Alyea E, Campbell B, Soiffer R. Important drug interactions in hematopoietic stem cell transplantation: what every physician should know. Biol Blood Marrow Transplant. 2012;18(7):989-1006. DOI: 10.1016/j.bbmt.2011.11.029

Manitpisitkul W, McCann E, Lee S, Weir MR. Drug interactions in transplant patients: what everyone should know. Curr Opin Nephrol Hypertens. 2009;18(5):404-11. DOI: 10.1097/MNH.0b013e32832edcb2

Hadjibabaie M, Badri S, Ataei S, Moslehi AH, Karimzadeh I, Ghavamzadeh A. Potential drug–drug interactions at a referral hematology–oncology ward in Iran: a cross-sectional study. Cancer Chemother Pharmacol. 2013;71(6):1619-27. DOI: 10.1007/s00280- 013-2162-5

Fernández de Palencia Espinosa MÁ, Díaz Carrasco MS, Sánchez Salinas A, de la Rubia Nieto A, Espuny Miró A. Potential drug-drug interactions in hospitalised haematological patients. J Oncol Pharm Pract Off Publ Int Soc Oncol Pharm Pract. 2017;23(6):443-53. DOI: 10.1177/1078155216664201

Gholaminezhad S, Hadjibabaie M, Gholami K, Javadi MR, Radfar M, Karimzadeh I, et al. Pattern and associated factors of potential drug-drug interactions in both pre- and early post-hematopoietic stem cell transplantation stages at a referral center in the Middle East. Ann Hematol. 2014;93(11):1913-22. DOI: 10.1007/s00277- 014-2122-0

Egger SS, Meier S, Leu C, Christen S, Gratwohl A, Krähenbühl S, et al. Drug interactions and adverse events associated with antimycotic drugs used for invasive aspergillosis in hematopoietic SCT. Bone Marrow Transplant. 2010;45(7): 1197-203. DOI: 10.1038/bmt.2009.325

Guastaldi RBF, Secoli SR. Drug interactions of anti-microbial agents used in hematopoietic stem cell transplantation. Rev Lat Am Enfermagem. 2011;19(4):960-7. DOI: 10.1590/s0104- 11692011000400015

Jaklič A, Collins CJ, Mrhar A, Sorror ML, Sandmaier BM, Bemer MJ, et al. High prevalence of potential drug interactions affecting mycophenolic acid pharmacokinetics in nonmyeloablative hematopoietic stem cell transplant recipients. Int J Clin Pharmacol Ther. 2013;51(9):711-7. DOI: 10.5414/CP201884

Sánchez L, Bacle A, Lamy T, Le Corre P. Potential drug–drug interactions and nephrotoxicity in hematopoietic stem cell transplant adult recipients during bone marrow transplantation unit stay. Cancer Chemother Pharmacol. 2019;83(5):827-35. DOI: 10.1007/s00280-019-03791-9

Guastaldi RBF, Reis AMM, Figueras A, Secoli SR. Prevalence of potential drug–drug interactions in bone marrow transplant patients. Int J Clin Pharm. 2011;33(6):1002-9. DOI: 10.1007/s11096-011- 9574-2

Trevisan DD, Silva JB, Oliveira HC, Secoli SR, Lima MHM. Prevalence and clinical significance of potential drug-drug interaction in hematopoietic stem cell transplantation. Cancer Chemother Pharmacol. 2015;75(2):393-400. DOI: 10.1007/s00280-014-2657-8

Leather H, Boyette RM, Tian L, Wingard JR. Pharmacokinetic evaluation of the drug interaction between intravenous itraconazole and intravenous tacrolimus or intravenous cyclosporin A in allogeneic hematopoietic stem cell transplant recipients. Biol Blood Marrow Transplant. 2006;12(3):325-34. DOI: 10.1016/j.bbmt.2005.10.022

Kawazoe H, Takiguchi Y, Tanaka H, Fukuoka N, Ohnishi H, Ishida T, et al. Change of the blood concentration of tacrolimus after the switch from fluconazole to voriconazole in patients receiving allogeneic hematopoietic stem cell transplantation. Biol Pharm Bull. 2006;29(12):2528-31. DOI: 10.1248/bpb.29.2528

Mihara A, Mori T, Aisa Y, Yamazaki R, Iketani O, Tanigawara Y, et al. Greater impact of oral fluconazole on drug interaction with intravenous calcineurin inhibitors as compared with intravenous fluconazole. Eur J Clin Pharmacol. 2008;64(1):89-91. DOI: 10.1007/s00228-007-0395-0

Mori T, Aisa Y, Kato J, Nakamura Y, Ikeda Y, Okamoto S. Drug interaction between oral solution itraconazole and calcineurin inhibitors in allogeneic hematopoietic stem cell transplantation recipients: an association with bioavailability of oral solution itraconazole. Int J Hematol. 2009;90(1):103-7. DOI: 10.1007/s12185-009-0344-z

Nara M, Takahashi N, Miura M, Saitoh H, Kagaya H, Sawada K. Effect of oral itraconazole on the pharmacokinetics of tacrolimus in a hematopoietic stem cell transplant recipient with CYP3A5*3/*3. Am J Hematol. 2010;85(8):634-5. DOI: 10.1002/ajh.21759

Mori T, Kato J, Yamane A, Sakurai M, Kohashi S, Kikuchi T, et al. Drug interaction between voriconazole and tacrolimus and its association with the bioavailability of oral voriconazole in recipients of allogeneic hematopoietic stem cell transplantation. Int J Hematol. 2012;95(5):564-9. DOI: 10.1007/s12185-012-1057-2

Kikuchi T, Mori T, Yamane A, Kato J, Kohashi S, Okamoto S. Variable magnitude of drug interaction between oral voriconazole and cyclosporine A in recipients of allogeneic hematopoietic stem cell transplantation. Clin Transplant. 2012;26(5):E544-8. DOI: 10.1111/ctr.12016

Nara M, Takahashi N, Miura M, Niioka T, Kagaya H, Fujishima N, et al. Effect of itraconazole on the concentrations of tacrolimus and cyclosporine in the blood of patients receiving allogeneic hematopoietic stem cell transplants. Eur J Clin Pharmacol. 2013;69(6):1321-9. DOI: 10.1007/s00228-013-1471-2

Iwamoto T, Monma F, Fujieda A, Nakatani K, Gayle AA, Nobori T, et al. Effect of genetic polymorphism of CYP3A5 and CYP2C19 and concomitant use of voriconazole on blood tacrolimus concentration in patients receiving hematopoietic stem cell transplantation. Ther Drug Monit. 2015;37(5):581-8. DOI: 10.1097/FTD.0000000000000182

El-Asmar J, González R, Bookout R, Mishra A, Kharfan-Dabaja MA. Clotrimazole troches induce supratherapeutic blood levels of sirolimus and tacrolimus in an allogeneic hematopoietic cell- transplant recipient resulting in acute kidney injury. Hematol Oncol Stem Cell Ther. 2016;9(4):157-61. DOI: 10.1016/j.hemonc.2015.11.001

Masoumi HT, Hadjibabaie M, Vaezi M, Ghavamzadeh A. Evaluation of the interaction of intravenous and oral voriconazole with oral cyclosporine in iranian HSCT patients. J Res Pharm Pract. 2017;6(2):77-82. DOI: 10.4103/jrpp.jrpp_16_163

Valenzuela R, Torres JP, Salas C, Gajardo I, Palma J, Catalán P, et al. Evaluación de interacción medicamentosa de voriconazol- ciclosporina en pacientes pediátricos que reciben trasplante de precursores hematopoyéticos (2013-2014). Rev Chil Infectol. 2017;34(1):14-8. DOI: 10.4067/S0716-10182017000100002

Kieu V, Jhangiani K, Dadwal S, Nakamura R, Pon D. Effect of isavuconazole on tacrolimus and sirolimus serum concentrations in allogeneic hematopoietic stem cell transplant patients: A drug-drug interaction study. Transpl Infect Dis. 2019;21(1):e13007. DOI: 10.1111/tid.13007

Collins J, Shea K, Parsad S, Plach K, Lee P. The impact of initiating posaconazole on tacrolimus pharmacokinetics in allogeneic stem cell transplantation. J Oncol Pharm Pract [Internet]. 2019 [accessed 02/01/2020]. Available at: https://journals.sagepub.com/doi/10.1177/1078155219833440

Mimura A, Yamaori S, Ikemura N, Katsuyama Y, Matsuzawa N, Ohmori S. Influence of azole antifungal drugs on blood tacrolimus levels after switching from intravenous tacrolimus to once-daily modified release tacrolimus in patients receiving allogeneic hematopoietic stem cell transplantation. J Clin Pharm Ther. 2019;44(4):565-71. DOI: 10.1111/jcpt.12834

Utano T, Kato M, Osumi T, Shioda Y, Kiyotani C, Terashima K, et al. Tacrolimus blood concentration increase depends on administration route when combined with voriconazole in pediatric stem cell transplant recipients. Pediatr Transplant. 2020;24(1):e13619. DOI: 10.1111/petr.13619

Marty FM, Lowry CM, Cutler CS, Campbell BJ, Fiumara K, Baden LR, et al. Voriconazole and sirolimus coadministration after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2006;12(5):552-9. DOI: 10.1016/j.bbmt.2005.12.032

Said A, Garnick JJ, Dieterle N, Peres E, Abidi MH, Ibrahim RB. Sirolimus-itraconazole interaction in a hematopoietic stem cell transplant recipient. Pharmacother J Hum Pharmacol Drug Ther. 2006;26(2):289-95. DOI: 10.1592/phco.26.2.289

Kubiak DW, Koo S, Hammond SP, Armand P, Baden LR, Antin JH, et al. Safety of posaconazole and sirolimus coadministration in allogeneic hematopoietic stem cell transplants. Biol Blood Marrow Transplant. 2012;18(9):1462-5. DOI: 10.1016/j.bbmt.2012.04.015

Ceberio I, Dai K, Devlin SM, Barke JN, Castro-Malaspina H, Goldberg JD, et al. Safety of voriconazole and sirolimus coadministration after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2015;50(3):438-43. DOI: 10.1038/bmt.2014.286

Greco R, Barbanti MC, Lupo Stranghellini M, Giglio F, Morelli M, Messina C, et al. Coadministration of posaconazole and sirolimus in allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant Lond. 2016;51(7):1022-4. DOI: 10.1038/bmt.2016.112

Nwaroh E, Jupp J, Jadusingh E, Guilcher G. Clinical impact and management of fluconazole discontinuation on sirolimus levels in bone marrow transplant patients. J Oncol Pharm Pract. 2018;24(3):235-8. DOI: 10.1177/1078155217701293

Marr KA, Leisenring W, Crippa F, Slattery JT, Corey L, Boeckh M, et al. Cyclophosphamide metabolism is affected by azole antifungals. Blood. 2004;103(4):1557-9. DOI: 10.1182/blood-2003-07-2512

Miura M, Takahashi N, Kanno S, Kato S, Nara M, Itoh M, et al. Drug interaction of (S)-warfarin, and not (R)-warfarin, with itraconazole in a hematopoietic stem cell transplant recipient. Clin Chim Acta Int J Clin Chem. 2011;412(21-22):2002-6. DOI: 10.1016/j.cca.2011.06.035

El Fakih R, Obi GA, Scholoff A, Carrum G, Kamble RT. Systemic effects of oral budesonide in hematopoietic transplant: implications of drug interaction with azoles. Bone Marrow Transplant. 2012;47(10):1370-1. DOI: 10.1038/bmt.2012.17

Yasu T, Konuma T, Kato S, Kurokawa Y, Takahashi S, Tojo A. Different effects of lansoprazole and rabeprazole on the plasma voriconazole trough levels in allogeneic hematopoietic cell transplant recipients. Ann Hematol. 2016;95(11):1845-51. DOI: 10.1007/s00277-016-2782-z

Furrer K, Schaffner A, Vavricka SR, Halter J, Imbof A, Schanz U. Nephrotoxicity of cyclosporine A and amphotericin B-deoxycholate as continuous infusion in allogenic stem cell transplantation. Swiss Med Wkly. 2002;132(23-24):316-20.

Nagamura F, Takahashi T, Takeuchi M, Iseki T, Ooi J, Tomonari A, et al. Effect of cyclophosphamide on serum cyclosporine levels at the conditioning of hematopoietic stem cell transplantation. Bone Marrow Transplant Lond. 2003;32(11):1051-8. DOI: 10.1038/sj.bmt.1704259

Ibrahim RB, Abidi MH, Ayash LJ, Cronin SM, Cadotte C, Mulawa J, et al. Effect of aprepitant on intravenous tacrolimus disposition in reduced intensity hematopoietic stem cell transplantation. J Oncol Pharm Pract. 2008;14(3):113-21. DOI: 10.1177/1078155208089846

Shayani S, Palmer JM, Stiller T, Chan H, Keuylian S, Parker P, et al. Aprepitant (Emend) significantly increases sirolimus levels in patients undergoing allogeneic hematopoietic SCT. Bone Marrow Transplant. 2012;47(2):291-3. DOI: 10.1038/bmt.2011.42

Fukuoka N, Imataki O, Ohnishi H, Kitanaka A, Kubota Y, Ishida T, et al. Micafungin does not influence the concentration of tacrolimus in patients after allogeneic hematopoietic stem cell transplantation. Transplant Proc. 2010;42(7):2725-30. DOI: 10.1016/j.transproceed.2010.04.030

Inoue Y, Saito T, Ogawa K, Nishio Y, Kosugi S, Suzuki Y, et al. Drug interactions between micafungin at high doses and cyclosporine A in febrile neutropenia patients after allogeneic hematopoietic stem cell transplantation. Int J Clin Pharmacol Ther. 2012;50(11):831-7. DOI: 10.5414/CP201738

Nishimoto M, Koh H, Tokuwame A, Makuuchi Y, Kuno M, Takakuwa T, et al. Drug interactions and safety profiles with concomitant use of caspofungin and calcineurin inhibitors in allogeneic haematopoietic cell transplantation. Br J Clin Pharmacol. 2017;83(9):2000-7. DOI: 10.1111/bcp.13303

Miceli M, Cronin S, Ayash L, Alangaden G, Chandrasekar PH. Significant interaction of tacrolimus with ritonavir during allogeneic hematopoietic SCT in an HIVinfected patient. Bone Marrow Transplant. 2012;47(8):1140-2. DOI: 10.1038/bmt.2011.230

Bernard E, Goutelle S, Bertrand Y, Bleyzac N. Pharmacokinetic drug-drug interaction of calcium channel blockers with cyclosporine in hematopoietic stem cell transplant children. Ann Pharmacother. 2014;48(12):1580-4. DOI: 10.1177/1060028014550644

Bleyzac N, Kebaili K, Mialou V, Bertrand Y, Goutelle S. Pharmacokinetic drug interaction between cyclosporine and imatinib in bone marrow transplant children and model-based reappraisal of imatinib drug interaction profile. Ther Drug Monit. 2014;36(6):724- 9.

Atiq F, Broers AEC, Andrews LM, Doorduijn JK, Koch BCP, Van Gelder T, et al. A clinically relevant pharmacokinetic interaction between cyclosporine and imatinib. Eur J Clin Pharmacol. 2016;72(6):719-23. DOI: 10.1007/s00228-016-2038-9

Kitazawa F, Fuchida SI, Kado Y, Ueda K, Kokufu T, Okano A, et al. Pharmacokinetic interaction between tacrolimus and fentanyl in patients receiving allogeneic hematopoietic stem cell transplantation. Ann Transplant. 2017;22:575-80. DOI: 10.12659/aot.904505

Guo Y, Abumiya M, Yamashita T, Ubukawa K, Takahashi N. Pharmacokinetics of tacrolimus coadministered with letermovir in allogeneic hematopoietic stem cell transplantation patients. Clin Pharmacol Drug Dev. 2019;8(3):411-2. DOI: 10.1002/cpdd.669

Maples KT, Maloy M, Devlin S, Lin A, DeRespiris L, Griffin M, et al. Lack of a significant pharmacokinetic interaction between letermovir and calcineurin inhibitors in allogeneic HCT recipients. Bone Marrow Transplant [Internet]. 2020 [accessed 02/01/2020]. Available at: http://www.nature.com/articles/s41409-020-0785-9

Mancini R, LaMontagne L, Williams T, Kreisle W, Petersen F. Midostaurin and cyclosporine drug interaction: A case report. J Clin Pharm Ther. 2020;45(2):384-7. DOI: 10.1111/jcpt.13077

Nilsson C, Aschan J, Hentschke P, Ringdén O, Ljungman P, Hassan M. The effect of metronidazole on busulfan pharmacokinetics in patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant. 2003;31(6):429-35. DOI: 10.1038/sj.bmt.1703896

Chung H, Yu KS, Hong KT, Choi JY, Hong CR, Kang HJ, et al. A significant influence of metronidazole on busulfan pharmacokinetics: a case report of therapeutic drug monitoring. Ther Drug Monit. 2017;39(3):208-10. DOI: 10.1097/FTD.0000000000000395

Sjöö F, Aschan J, Barkholt L, Hassan Z, Ringdén O, Hassan M. N- acetyl-L-cysteine does not affect the pharmacokinetics or myelosuppressive effect of busulfan during conditioning prior to allogeneic stem cell transplantation. Bone Marrow Transplant. 2003;32(4):349-54. DOI: 10.1038/sj.bmt.1704143

De Castro FA, Lanchote VL, Voltarelli JC, Colturato VAR, Simões BP. Influence of fludarabine on the pharmacokinetics of oral busulfan during pretransplant conditioning for hematopoietic stem cell transplantation. J Clin Pharmacol. 2013;53(11):1205-11. DOI: 10.1002/jcph.130

Sweiss K, Quigley JG, Oh A, Lee J, Ye R, Rondelli D, et al. A novel drug interaction between busulfan and blinatumomab. J Oncol Pharm Pract. 2019;25(1):226-8. DOI: 10.1177/1078155217729745

Bubalo JS, Cherala G, McCune JS, Munar MY, Tse S, Maziarz R. Aprepitant pharmacokinetics and assessing the impact of aprepitant on cyclophosphamide metabolism in cancer patients undergoing hematopoietic stem cell transplantation. J Clin Pharmacol. 2012;52(4):586-94. DOI: 10.1177/0091270011398243

Wasko JA, Westholder JS, Jacobson PA. Rifampin–sirolimus– voriconazole interaction in a hematopoietic cell transplant recipient. J Oncol Pharm Pract. 2017;23(1):75-9. DOI: 10.1177/1078155215624263

Engle JA, Fair C. Sirolimus and mirabegron interaction in a hematopoietic cell transplant patient: J Oncol Pharm Pract [Internet]. 2017 [accessed 02/01/2020]. Available at: https://journals.sagepub.com/doi/10.1177/1078155217726161

Vitry AI. Comparative assessment of four drug interaction compendia. Br J Clin Pharmacol. 2007;63(6):709-14. DOI: 10.1111/j.1365-2125.2006.02809.x

Fernández de Palencia Espinosa MÁ, Espuny Miró A, Díaz Carrasco MS. Consistency among two drug interaction compendia in onco-haematological inpatients. Eur J Clin Pharm Aten Farm. 2016;18(2):90-7.

Fernández de Palencia Espinosa MÁ, Díaz Carrasco MS, Alonso Romero JL, de la Rubia Nieto A, Espuny Miró A. Potential drug-drug interactions in oncological adult inpatients at a Spanish hospital: epidemiology and risk factors. Int J Clin Pharm. 2015;37(6):1021-7. DOI: 10.1007/s11096-015-0195-z

Fernández de Palencia Espinosa MA, Díaz Carrasco MS, Fuster Soler JL, Ruiz Merino G, De la Rubia Nieto MA, Espuny Miró A. Pharmacoepidemiological study of drug-drug interactions in onco- hematological pediatric patients. Int J Clin Pharm. 2014;36(6):1160- 9. DOI: 10.1007/s11096-014-0011-1

Díaz-Carrasco MS, Almanchel-Rivadeneyra M, Tomás-Luiz A, Pelegrín-Montesinos S, Ramírez-Roig C, Fernández-Ávila JJ. Estudio observacional sobre interacciones farmacológicas en pacientes oncológicos ingresados. Farm Hosp. 2018;42(01):10-5. DOI: 10.7399/fh.10857

Popa MA, Wallace KJ, Brunello A, Extermann M, Balducci L. Potential drug interactions and chemotoxicity in older patients with cancer receiving chemotherapy. J Geriatr Oncol. 2014;5(3):307-14. DOI: 10.1016/j.jgo.2014.04.002

Stoll P, Kopittke L. Potential drug-drug interactions in hospitalized patients undergoing systemic chemotherapy: a prospective cohort study. Int J Clin Pharm. 2015;37(3):475-84. DOI: 10.1007/s11096-015-0083-6