Early renal injury after myeloablative cord blood transplantation in adults.
We report a retrospective analysis of acute renal failure (ARF) in a group of 54 adult patients with hematological malignancies treated with unrelated cord blood transplantation (CBT) after myeloablative conditioning. All patients received four fractionated 12 Gy total body irradiation and chemotherapy as myeloablative conditioning. ARF was defined as the doubling serum creatinine occurring within the first 100 days after CBT. A statistically significant decrement of renal function from baseline was observed in days between 11 and 20. ARF occurred in 27.8% of patients. Although no difference was seen in maximum cyclosporine trough levels, the maximum of vancomycin (VCM) trough levels were significantly higher in patients with ARF (p = 0.01). Our result suggests that it is important to monitor VCM dosing more strictly with pharmacokinetic assessment, especially in days 11 - 20, when the most frequently observed declining renal function.
Mae
Hiroshi
H
Department of Pharmacy, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
Ooi
Jun
J
Takahashi
Satoshi
S
Tomonari
Akira
A
Tsukada
Nobuhiro
N
Konuma
Takaaki
T
Hongo
Emi
E
Kato
Seiko
S
Kasahara
Senji
S
Oiwa-Monna
Maki
M
Kurokawa
Yosuke
Y
Tojo
Arinobu
A
Asano
Shigetaka
S
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use / Q000633:toxicity; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D016572:Cyclosporine / Q000008:administration & dosage; D005260:Female; D019337:Hematologic Neoplasms / Q000139:chemically induced / Q000628:therapy; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014640:Vancomycin / Q000008:administration & dosage / Q000633:toxicity*; D014916:Whole-Body Irradiation
D000970:Antineoplastic Agents; D014640:Vancomycin; D016572:Cyclosporine