Cyclosporine short infusion and C2 monitoring in haematopoietic stem cell transplant recipients.
until further notice
SourceBone Marrow Transplantation, 38, 7, (2006), pp. 521-525
Article / Letter to editor
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Bone Marrow Transplantation
SubjectCTR 2: Clinical Pharmacology and physiology; N4i 2: Invasive mycoses and compromised host; N4i 3: Poverty-related infectious diseases; NCEBP 13: Infectious diseases and international health; NCMLS 1: Immunity, infection and tissue repair; UMCN 3.2: Cognitive neurosciences; UMCN 4.1: Microbial pathogenesis and host defense; CTR 2: Clinical Pharmacology and physiology; UMCN 4.1: Microbial pathogenesis and host defense
Blood concentrations of cyclosporine A (CsA) >or=800 microg/l measured 2 h post-dosing, the C2 concentration, is necessary to obtain a maximal pharmacological effect and correlates well with transplant-related complications such as transplant rejection and toxicity. In an open crossover study CsA blood levels were measured during 24 h to generate a pharmacokinetic profile on days 1, 8 and 15 after starting CsA infusion in 21 haematopoietic allogeneic stem cell transplant recipients who were receiving intravenously CsA 3 mg/kg/day either by continuous infusion or by 2 h infusion given every 12 h. C2 levels after the 2 h infusion correlated better than C1 or C3 levels with the area under the concentration-time curve from 0 to 4 h (r2=0.62). C2 levels >or=800 microg/l were also achieved for 20 out of 24 (83%) of cases after the 2 h infusion of CsA without any increase of CsA-related toxicity but for only three of the 23 patients (13%) after continuous infusion. Therefore, we recommend CsA infusions in 2 h during transplant and perform C2 monitoring to obtain therapeutic C2 levels >or=800 microg/l.
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