Complications of Multi-Drug Regimens in Hematological Malignancies: A Case-Control Study
Keywords:
drug-drug interactions, hematological malignancies, polypharmacy, myelosuppression, hepatotoxicity, combination chemotherapy, pharmacovigilanceAbstract
Background: Polypharmacy in hematological malignancies creates complex drug–drug interaction (DDI) landscapes that frequently result in severe toxicity. Objective: To quantify the prevalence, type, and clinical impact of DDIs and drug-induced organ toxicity in patients receiving combination chemotherapy regimens compared to healthy controls. Methods: A prospective case-control study enrolled 42 hematology patients receiving multi-drug regimens and 42 matched healthy controls. Complete blood counts, liver enzymes, and renal function were recorded. DDIs were classified using the Micromedex® database. Results: Major DDIs were detected in 69.0% of patients versus 0% of controls (p<0.001). Anemia (78.6%), neutropenia (66.7%), elevated ALT (61.9%), and thrombocytopenia (52.4%) were significantly more prevalent in patients. Hospital stay was markedly prolonged in the patient group (median 22 vs. 2 days). Conclusion: Multi-drug hematology regimens impose a substantial burden of clinically significant DDIs and end-organ toxicity. Systematic pharmacist-led DDI screening and prospective biomarker monitoring are essential to mitigate these risks.
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