The consequences of tacrolimus blood concentrations during the four weeks following marrow transplantation from an unrelated donor: a single-center experience.
In our institute, tacrolimus was started at a dose of 0.03 mg/kg/day and adjusted to maintain a blood concentration between 10 and 20 ng/mL combined with short term methotrexate after bone marrow transplantation from an unrelated donor. Dose adjustment was performed strictly, in order to prevent grade II-IV acute graft-versus-host disease (GVHD)while avoiding renal toxicity of tacrolimus. Then, in this study, we retrospectively evaluated the tacrolimus blood concentration during the first 4 weeks after transplantation. The mean tacrolimus concentration of the eligible 52 patients was 17.41+/-4.84(range, 9.5-33.4)ng/mL in the 1st week after transplantation, but declined to 13.7+/- 4.0(range, 8.1-25.6)ng/mL in the 2nd week. The dose of tacrolimus was decreased as follows: 0.022+/-0.005 mg/ kg/day(range 0.011-0.039)in the 1st week, and 0.018+/-0.007 mg/kg/day(range 0.004-0.040)in the 2nd week. The incidence of grade II-IV GVHD was 63.0% and grade III-IV was 13.9%. The individual variations of tacrolimus blood concentration did not affect the incidence of grade II-IV acute GVHD, as far as the concentration being maintained in the range of 14.82+/-4.22 ng/mL during the first 4 weeks after transplantation. In addition, the variations of tacrolimus concentration didn?t associate statistically with renal toxicity.
Muta
Tsuyoshi
T
Department of Hematology, Hamanomachi Hospital, Fukuoka.
Kato
Koji
K
Gondo
Hisashi
H
Oku
Seido
S
Okeda
Aki
A
Kamo
Mieko
M
Nawata
Ryohei
R
Takase
Ken
K
Arima
Fumito
F
Shibuya
Tsunefumi
T
Eto
Testuya
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016559:Tacrolimus / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000009:adverse effects
D017964:Itraconazole; D016559:Tacrolimus