title: Comparison of continuous and twice-daily infusions of cyclosporine A for graft-versus-host-disease prophylaxis in pediatric hematopoietic stem cell transplantation.
abstract: Cyclosporine A (CsA) is used widely for graft-versus-host disease (GVHD) prophylaxis in hematopoietic stem cell transplantation (HSCT); however, the optimal schedule of its administration has not been established. Although comparative studies of adult patients undergoing HSCT have demonstrated enhanced efficacy and safety of twice-daily infusion (TD) compared with continuous infusion (CIF) of CsA, to our knowledge, similar studies have not yet been performed in pediatric groups.
  
  
  
  A self-administered questionnaire was used to retrospectively compare the clinical outcome and incidence of CsA-associated adverse events of 70 pediatric acute myelogenous leukemia patients who were receiving CsA by TD (n = 36) or CIF (n = 34) as GVHD prophylaxis for their first allogeneic HSCT.
  
  
  
  The cumulative incidences of grade II-IV acute GVHD and chronic GVHD, as well as the overall survival and event-free survival rates, did not differ significantly between the TD and CIF groups; however, the incidence of severe hypertension was significantly higher in the CIF group than the TD group.
  
  
  
  The analysis presented here indicates that TD and CIF administration of CsA have similar prophylactic effect on pediatric GVHD and suggest that TD is associated with a lower rate of toxicity than CIF in pediatric patients undergoing HSCT. Pediatr Blood Cancer 2015;62:291-298. © 2014 Wiley Periodicals, Inc.
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Katsutsugu
authors.initials: K
authors.lastname: Umeda
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Souichi
authors.initials: S
authors.lastname: Adachi
authors.affiliation: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics, Niigata Cancer Center Hospital, Niigata, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ogawa
authors.affiliation: Department of Pediatrics, Sapporo Medical University Hospital, Sapporo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Hatakeyama
authors.affiliation: Division of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Kudo
authors.affiliation: Department of Pediatrics, Kinki University, Faculty of Medicine, Osaka, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Sakata
authors.affiliation: Division of Pediatrics, Japanese Red Cross Narita Hospital, Narita, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Igarashi
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Kumi
authors.initials: K
authors.lastname: Ohshima
authors.affiliation: Center of Bone Marrow Transplantation, Ryukyu University Hospital, Okinawa, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hyakuna
authors.affiliation: Department of Pediatrics and Child Health, Nihon University Itabashi Hospital, Tokyo, Japan.
authors.forename: Motoaki
authors.initials: M
authors.lastname: Chin
authors.affiliation: Division of Hemato-oncology/Regeneration Medicine, Kanagawa Children's Medical Center, Kanagawa, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Goto
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Pediatrics and Cell Transplantation, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Azuma
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Koh
authors.affiliation: Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Sawada
authors.affiliation: Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.|Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Atsuta
authors.affiliation: Department of Hematology and Oncology, Kanazawa University Hospital, Kanazawa, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Takami
authors.affiliation: Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Murata
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000008:administration & dosage* / Q000627:therapeutic use / Q000633:toxicity; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use / Q000633:toxicity; D007223:Infant; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008727:Methotrexate
keywords: cyclosporine; graft-versus-host disease; hematopoietic stem cell transplantation; pediatric