Optimizing the oral dose of cyclosporine with concomitant posaconazole post stem cell allograft.

Publisher: Taylor & Francis Country of Publication: United States NLM ID: 9007422 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1029-2403 (Electronic) Linking ISSN: 10268022 NLM ISO Abbreviation: Leuk Lymphoma Subsets: MEDLINE

Publication: [Philadelphia, PA] : Taylor & Francis
Original Publication: Chur ; New York : London, UK : Harwood Academic Publishers ; Distributed by STBS, 1989-

Hematopoietic Stem Cell Transplantation*/adverse effects ; Graft vs Host Disease*/diagnosis ; Graft vs Host Disease*/etiology ; Graft vs Host Disease*/prevention & control; Humans ; Cyclosporine/adverse effects ; Retrospective Studies ; Immunosuppressive Agents/adverse effects ; Allografts

Cyclosporine is an immunosuppressive agent to prevent acute graft versus host disease (GVHD) in patients undergoing a stem cell allograft. It has a narrow therapeutic range, and its metabolism can be affected by posaconazole, commonly used as antifungal prophylaxis post allograft. There is limited evidence on the optimal oral cyclosporine starting dose in this setting. A delicate balance is required in dose adjustments to avoid toxic levels while maintaining sufficient drug concentrations to prevent GVHD. We undertook a retrospective audit of 28 patients undergoing their first allograft who received posaconazole and commenced on a starting oral cyclosporine dose of 2 mg/kg twice daily. Our key findings were that this starting dose was too high, with all patients experiencing at least one toxicity and an overall low incidence of GVHD.

Keywords: Transplantation; cyclosporine; drug toxicity; posaconazole

83HN0GTJ6D (Cyclosporine)
6TK1G07BHZ (posaconazole)
0 (Immunosuppressive Agents)

Date Created: 20221111 Date Completed: 20230222 Latest Revision: 20230306

20230306

10.1080/10428194.2022.2142054

36368718