Retrospective analysis of the correlation between tacrolimus concentrations measured in whole blood and variations of blood cell counts in patients undergoing allogeneic haematopoietic stem cell transplantation
Retrospective analysis of the correlation between tacrolimus concentrations measured in whole blood and variations of blood cell counts in patients undergoing allogeneic haematopoietic stem cell transplantation
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DOI：
10.1136/ejhpharm-2018-001663
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发表时间：
2020-03-01
影响因子：
1.7
通讯作者：
Ikeda, Ryuji
中科院分区：
文献类型：
--
作者：
Yoshikawa, Naoki;Urata, Shuhei;Ikeda, Ryuji
目的 他克莫司用于接受造血干细胞移植（HSCT）的患者，作为移植物抗宿主病的预防。由于HSCT后必须维持狭窄治疗范围内的高血他克莫司浓度，因此有必要进行治疗药物监测（TDM）。我们研究了 HSCT 患者血中他克莫司浓度与血细胞计数之间的相关性，以评估血细胞计数变化如何影响他克莫司 TDM。方法对 24 例接受同种异体 HSCT 并接受他克莫司治疗的患者进行回顾性分析。从HSCT后1周开始，连续三周评估他克莫司血浓度变化与血细胞计数之间的相关性。结果他克莫司血浓度变化与红细胞（RBC）计数、血红蛋白水平和红细胞比容值的变化显着相关，但与白细胞或血小板计数的变化无关。此外，上述变化在接受脐带血移植和外周血干细胞移植的患者中显着相关，但在接受骨髓移植的患者中则不然。 结论这些研究结果表明，红细胞计数与血液他克莫司浓度的变化相关，这种关联的相关性取决于输注干细胞的来源。因此，RBC 计数的变化可能对他克莫司 TDM 有用。
Objective Tacrolimus is administered to patients undergoing haematopoietic stem cell transplantation (HSCT) as prophylaxis for graft-versus-host disease. As a high blood tacrolimus concentration within a narrow therapeutic range must be maintained after HSCT, therapeutic drug monitoring (TDM) is necessary. We investigated the correlation between blood tacrolimus concentration and blood cell count in HSCT patients to assess how changes in blood cell count affect tacrolimus TDM.Methods A retrospective analysis was performed for 24 patients who underwent allogeneic HSCT and received tacrolimus. The correlation between variations in blood tacrolimus concentration and blood cell count was evaluated for three consecutive weeks, starting 1week after HSCT.Results Variations in blood tacrolimus concentration were significantly correlated with variations in red blood cell (RBC) count, haemoglobin level and haematocrit value, but not with variations in white blood cell or platelet counts. Further, the above variations were significantly correlated in patients undergoing cord blood transplantation and peripheral blood stem cell transplantation, but not in those undergoing bone marrow transplantation.Conclusions These findings demonstrate that RBC count is associated with variations in blood tacrolimus concentration, with the relevance of this association depending on the source of transfused stem cells. Thus, variations in RBC count might be useful for tacrolimus TDM.