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      Dried Blood Spot Sampling for Tacrolimus and Mycophenolic Acid in Children : Analytical and Clinical Validation

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          Abstract

          <p class="first" id="d5854637e114">Tacrolimus and mycophenolic acid (MPA) are the backbone of immunosuppressive therapy after pediatric kidney transplantation. Dosing of these drugs is individualized by therapeutic drug monitoring. Dried blood spot (DBS) sampling may prove beneficial over conventional venous sampling. We aimed to develop and clinically validate a DBS method for tacrolimus and MPA in children. </p>

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          Some suggestions for measuring predictive performance.

          L Sheiner, Deryk S. Beal (1981)
          The performance of a prediction or measurement model is often evaluated by computing the correlation coefficient and/or the regression of predictions on true (reference) values. These provide, however, only a poor description of predictive performance. The mean square prediction error (precision) and the mean prediction error (bias) provide better descriptions of predictive performance. These quantities are easily computed, and can be used to compare prediction methods to absolute standards or to one another. The measures, however, are unreliable when the reference method is imprecise. The use of these measures is discussed and illustrated.
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            Dried blood spot sampling in combination with LC-MS/MS for quantitative analysis of small molecules.

            Wenkui Li, Francis Tse (2009)
            The collection of whole blood samples on paper, known as dried blood spot (DBS), dates back to the early 1960s in newborn screening for inherited metabolic disorders. DBS offers a number of advantages over conventional blood collection. As a less invasive sampling method, DBS offers simpler sample collection and storage and easier transfer, with reduced infection risk of various pathogens, and requires a smaller blood volume. To date, DBS-LC-MS/MS has emerged as an important method for quantitative analysis of small molecules. Despite the increasing popularity of DBS-LC-MS/MS, the method has its limitations in assay sensitivity due to the small sample size. Sample quality is often a concern. Systematic assessment on the potential impact of various blood sample properties on accurate quantification of analyte of interest is necessary. Whereas most analytes may be stable on DBS, unstable compounds present another challenge for DBS as enzyme inhibitors cannot be conveniently mixed during sample collection. Improvements on the chemistry of DBS card are desirable. In addition to capturing many representative DBS-LS-MS/MS applications, this review highlights some important aspects of developing and validating a rugged DBS-LC-MS/MS method for quantitative analysis of small molecules along with DBS sample collection, processing and storage.
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              Therapeutic Drug Monitoring by Dried Blood Spot: Progress to Date and Future Directions

              Abraham Wilhelm, Jeroen den Burger, Eleonora L Swart (2014)
              This article discusses dried blood spot (DBS) sampling in therapeutic drug monitoring (TDM). The most important advantages of DBS sampling in TDM are the minimally invasive procedure of a finger prick (home sampling), the small volume (children), and the stability of the analyte. Many assays in DBS have been reported in the literature over the previous 5 years. These assays and their analytical techniques are reviewed here. Factors that may influence the accuracy and reproducibility of DBS methods are also discussed. Important issues are the correlation with plasma/serum concentrations and the influence of hematocrit on spot size and recovery. The different substrate materials are considered. DBS sampling can be a valid alternative to conventional venous sampling. However, patient correlation studies are indispensable to prove this. Promising developments are dried plasma spots using membrane and hematocrit correction using the potassium concentration.
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                Author and article information

                Journal
                Title: Therapeutic Drug Monitoring
                Abbreviated Title: Therapeutic Drug Monitoring
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Print): 0163-4356
                Publication date Created: 2017
                Publication date (Print): August 2017
                Volume: 39
                Issue: 4
                Pages: 412-421
                Article
                DOI: 10.1097/FTD.0000000000000422
                PubMed ID: 28700522
                SO-VID: 74903d0e-391f-4b31-893d-35f23bdbdc99
                Copyright © © 2017
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