Relationship of tacrolimus whole blood levels to efficacy and safety outcomes after unrelated donor marrow transplantation.
Relationship of tacrolimus whole blood levels to efficacy and safety outcomes after unrelated donor marrow transplantation.
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DOI：
10.1053/bbmt.1999.v5.pm10371361
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发表时间：
1999-01-01
期刊：
影响因子：
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通讯作者：
Fay, J W
中科院分区：
文献类型：
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作者：
Przepiorka, D;Nash, R A;Fay, J W
他克莫司已被证明对预防非血缘关系供者骨髓移植后的急性移植物抗宿主病(GVHD)有效，但治疗窗口明显较窄。治疗性药物监测可能被用于指导剂量调整，但他克莫司血药浓度的最佳目标范围尚不清楚。我们通过IMX试验确定急性移植物抗宿主病和肾功能不全是否与他克莫司全血浓度相关。在一项多中心试验中，97名成人接受了他克莫司、甲氨蝶呤或甲基强的松龙预防无关供者骨髓移植后移植物抗宿主病治疗的数据分析。II-IV级移植物抗宿主病的发生率为49%；81%的患者血清肌酐增加一倍；61%的患者血清肌酐增加
Tacrolimus has proved effective for preventing acute graft-vs.-host disease (GVHD) after unrelated donor marrow transplantation, but the therapeutic window is apparently narrow. Therapeutic drug monitoring could potentially be used to guide dose modifications, but the optimal target range of tacrolimus blood concentrations is unknown. We determined whether acute GVHD and renal dysfunction correlated with tacrolimus whole blood levels as measured by the IMx assay. Data were analyzed for 97 adults treated in a multicenter trial of tacrolimus and methotrexate or methylprednisolone as GVHD prophylaxis after unrelated donor marrow transplantation. The rate of grades II-IV GVHD was 49%; 81% of patients had a doubling of the serum creatinine; and 61% had a serum creatinine