Tacrolimus in hematopoietic stem cell transplantation.
BACKGROUND
Graft-versus-host disease (GVHD) associated with allogeneic peripheral blood or marrow transplantation is a serious life-threatening complication. Most of the available literature support the use of tacrolimus as a prophylactic agent for acute GVHD.


OBJECTIVE
To review the pharmacology, efficacy and safety of tacrolimus and recommend its place in therapy for the prophylaxis of GVHD.


METHODS
We conducted a literature search using PubMed/Medline (January 1996 - December 2008) using the keywords tacrolimus, graft-versus-host disease and hematopoietic stem cell transplantation. Data provided by the manufacturer and the FDA were also reviewed.


CONCLUSIONS
Tacrolimus is effective in the prevention of acute GVHD. Trials comparing tacrolimus with cyclosporine using tacrolimus levels in the 7 - 10 ng/ml range and with larger numbers of patients may be necessary to better understand the impact of these drugs on survival.
Fortune
Kara
K
Centennial Medical Center, Nashville, TN 37203, USA. kfortune@tnonc.com
Couriel
Daniel
D
D000818:Animals; D002986:Clinical Trials as Topic / Q000379:methods; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D016559:Tacrolimus / Q000494:pharmacology / Q000627:therapeutic use*
D007166:Immunosuppressive Agents; D016559:Tacrolimus