Monitoring cyclosporin concentrations in marrow transplant recipients: comparison of two assay methods.
Renal dysfunction is the major dose-limiting toxicity associated with cyclosporin therapy. We have previously shown in patients undergoing allogeneic bone marrow transplantation that serum cyclosporin concentrations, as measured by radioimmunoassay (RIA), correlate significantly with the development of renal dysfunction. However, since the RIA measures both parent drug and metabolites, the relative role of each in the development of nephrotoxicity could not be determined. Therefore, we re-measured cyclosporin concentrations in the same serum samples by high-performance liquid chromatography (h.p.l.c.). Serum cyclosporin concentrations of less than 50, 50-100 and greater than 100 ng/ml, as measured by h.p.l.c., were considered equivalent to cyclosporin concentrations of less than 150, 150-250 and greater than 250 ng/ml, as measured by RIA. Contrary to results by RIA, cyclosporin concentrations measured by h.p.l.c. did not significantly correlate with renal dysfunction, which suggests that measurement of serum cyclosporin concentrations by h.p.l.c. provides no clinical advantage to RIA for monitoring cyclosporin concentrations to prevent renal dysfunction.
Yee
G C
GC
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
Kennedy
M S
MS
Gmur
D J
DJ
Self
S G
SG
Deeg
H J
HJ
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002851:Chromatography, High Pressure Liquid; D003404:Creatinine / Q000097:blood; D003524:Cyclosporins / Q000097:blood*; D006801:Humans; D007677:Kidney Function Tests; D008991:Monitoring, Physiologic; D011863:Radioimmunoassay
D003524:Cyclosporins; D003404:Creatinine