Effect of blood cyclosporine concentration on the outcome of hematopoietec stem cell transplantation from an HLA-matched sibling donor

Yoshinobu Kanda, Rie Hyo, Takuya Yamashita, Katsumichi Fujimaki, Kumi Oshima, Masahiro Onoda, Takehiko Mori, Toru Sakura, Masatsugu Tanaka, Miwa Sakai, Jun Taguchi, Mineo Kurakawa, Atsuo Maruta, Shinichiro Okamoto, Hisashi Sakamaki

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

We retrospectively evaluated the effect of the blood cyclosporine (CsA) concentration on the outcome of allogeneic hematopoietic stem cell transplantation from an HLA-matched sibling donor in 171 patients who received a continuous infusion of CsA and short-course methotrexate to prevent graft-versus-host disease (GVHD). CsA was started at 3.0 mg/kg/day and the dose was adjusted to maintain the blood CsA concentration between 250 and 350 ng/ml. The actual dose of CsA averaged 1.9 mg/kg/day at the 3rd week after transplantation. The incidence of grade II-IV acute GVHD was 29.9%. Patient age and sex were identified as independent significant risk factors for acute GVHD. The CsA concentration during the 3rd week after transplantation most strongly affected the incidence of grade II-IV acute GVHD (RR 0.995 for an increase in CsA concentration by 1 ng/ml, P = 0.037) adjusted for other risk factors. The incidence of acute GVHD was significantly lower in patients with a 3rd-week CsA concentration higher than 300 ng/ml than in those with values between 200 and 300 ng/ml (20% vs. 35%, P = 0.036). We concluded that the blood CsA concentration at peri-engraftment period may be important in preventing acute GVHD.

Original languageEnglish
Pages (from-to)838-844
Number of pages7
JournalAmerican journal of hematology
Volume81
Issue number11
DOIs
Publication statusPublished - 2006 Nov

Keywords

  • Blood concentration
  • Continuous infusion
  • Cyclosporine
  • Graft-versus-host disease
  • Hematopoietic stem cell transplantation

ASJC Scopus subject areas

  • Hematology

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