title: The consequences of tacrolimus blood concentrations during the four weeks following marrow transplantation from an unrelated donor: a single-center experience.
abstract: 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.
authors.affiliation: Department of Hematology, Hamanomachi Hospital, Fukuoka.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Muta
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.forename: Hisashi
authors.initials: H
authors.lastname: Gondo
authors.forename: Seido
authors.initials: S
authors.lastname: Oku
authors.forename: Aki
authors.initials: A
authors.lastname: Okeda
authors.forename: Mieko
authors.initials: M
authors.lastname: Kamo
authors.forename: Ryohei
authors.initials: R
authors.lastname: Nawata
authors.forename: Ken
authors.initials: K
authors.lastname: Takase
authors.forename: Fumito
authors.initials: F
authors.lastname: Arima
authors.forename: Tsunefumi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Testuya
authors.initials: T
authors.lastname: Eto
mesh_terms: 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
chemical_list: D017964:Itraconazole; D016559:Tacrolimus