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International Journal of Hematology

, Volume 83, Issue 2, pp 159–163 | Cite as

Single-Dose Daily Infusion of Cyclosporine for Prevention of Graft-versus-Host Disease after Allogeneic Bone Marrow Transplantation from HLA Allele-Matched, Unrelated Donors

  • Yuichiro Nawa
  • Masamichi Hara
  • Kazushi Tanimoto
  • Koichi Nakase
  • Teruhiko Kozuka
  • Yoshinobu Maeda
Article

Abstract

Peak blood concentration of cyclosporine (CsA) in renal transplantation patients was recently reported to be associated with clinical efficacy.We therefore evaluated the toxicity and efficacy of a regimen of once-daily infusion of CsA plus a short course of methotrexate as prophylaxis of graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation from an HLA allele-matched, unrelated donor. Nineteen patients with hematologic malignancies received CsA, 3 mg/kg per day, as a 4-hour intravenous (IV) infusion from day -1. After engraftment, patients received CsA orally at twice the IV dose. The CsA dose was adjusted to maintain the blood trough level between 150 and 200 ng/mL. Methotrexate was administered IV at doses of 10 mg/m2 on day 1 and 7 mg/m2 on days 3, 6, and 11. Bone marrow engraftment occurred in all patients. Grade 1 and grade 2 GVHD occurred in 6 (31.6%) and 7 (36.8%) of the 19 patients, respectively. No patient had grade 3 or 4 GVHD. Acute nephrotoxicity developed in 1 (5.3%) of the 19 patients, and hypertension developed in 3 (15.8%) of the 19 patients.We evaluated the pharmacokinetics of 4-hour CsA infusion in 10 patients.The mean trough concentration, mean peak concentration, mean time to peak concentration, and area under the curve (24 hours) were 161 ± 43 ng/mL, 1498 ± 387 ng/mL, 3.2 ± 1.0 hours, and 10,848 ± 1,991 ng ± h/mL, respectively. This regimen was well tolerated and did not enhance the risk of severe GVHD in patients undergoing allogeneic bone marrow transplantation from an HLA allele-matched, unrelated donor.

Key words

CsA Short infusion Graft-versus-host disease Matched unrelated donor 

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Copyright information

© The Japanese Society of Hematology 2006

Authors and Affiliations

  • Yuichiro Nawa
    • 1
  • Masamichi Hara
    • 1
  • Kazushi Tanimoto
    • 1
  • Koichi Nakase
    • 1
  • Teruhiko Kozuka
    • 1
  • Yoshinobu Maeda
    • 1
  1. 1.Division of HematologyEhime Prefectural Central HospitalEhimeJapan

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