Zidovudine (AZT)
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DRUG-ZIDOVUDINE |
|---|---|
| Тип | Препарат |
| Синоніми | AZTAzidothymidineCombivir (with lamivudine)RetrovirTrizivir (with lamivudine + abacavir)ZDVZidovudineЗидовудин (АЗТ) |
| Статус | переглянуто 2026-04-26 | очікує клінічного підпису |
| Хвороби | DIS-ATLL |
| Джерела | SRC-NCCN-BCELL-2025 |
Дані про препарат
| Клас | antiviral — nucleoside reverse-transcriptase inhibitor (NRTI), thymidine analog |
|---|---|
| Механізм дії | Thymidine analog; intracellularly phosphorylated by thymidine kinase / thymidylate kinase / nucleoside diphosphate kinase to ZDV-triphosphate, which competes with dTTP for HIV-1 / HTLV-1 reverse transcriptase and acts as an obligate chain terminator (lacks 3'-OH for further elongation). In HTLV-1-driven adult T-cell leukemia / lymphoma (ATLL), AZT combined with IFN-α exerts antineoplastic activity not solely attributable to reverse-transcriptase inhibition: induces apoptosis via NF-κB pathway suppression, downregulates HTLV-1 Tax-mediated cell-cycle drive, and synergizes with type-I interferon antiproliferative signaling (Bazarbachi 2010 meta-analysis: ~50% durable CR in indolent ATLL). |
| Типове дозування | ATLL (AZT/IFN-α regimen, Bazarbachi 2010): zidovudine 200 mg PO 5× daily (≈1000 mg/day) continuous, with IFN-α 5-9 MU SC daily for first 2 months then 3× weekly maintenance. Continue until progression / intolerance. HIV reference dose (for context): 300 mg PO BID or 200 mg PO TID. Dose-reduce for renal impairment (CrCl <15 → 100 mg PO TID); dose- reduce for severe anemia (Hgb <7.5) or neutropenia (ANC <0.75). |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | True |
| Остання перевірка для України | 2026-04-27 |
Застереження
- Hematologic toxicity — anemia (often severe, transfusion-dependent), neutropenia
- Symptomatic myopathy with prolonged use
- Lactic acidosis with severe hepatomegaly / steatosis (mitochondrial toxicity, can be fatal)
Нотатки
ATLL indolent (chronic / smoldering) subtypes: AZT + IFN-α gives durable remissions and OS benefit (Bazarbachi 2010 international meta-analysis: 5-yr OS 46% AZT/IFN vs 20% chemo in chronic ATLL). Aggressive ATLL (acute / lymphoma type): AZT/IFN inferior to CHOP-based induction; combined modality (chemotherapy → AZT/IFN maintenance) is being studied. Macrocytosis is expected and not a sign of B12 / folate deficiency — do not work up unless Hgb drops disproportionately. Mandatory monitoring: CBC weekly × 4 then monthly, lactate if symptomatic, hepatic panel monthly.
Де використовується
Regimens
REG-AZT-IFN-A- AZT (zidovudine) + IFN-α — continuous, dose-adjusted