Research Papers:
Blood concentration of cyclosporine during early posttransplant period may have influence on the occurrence of chronic graft versus host disease in patients who received allogeneic hematopoietic stem cell transplantation
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Silvia Park1, Kihyun Kim1, Jun Ho Jang1, Seok Jin Kim1, Won Seog Kim1, Chul Won Jung1
1Division of Hematology-Oncology, Department of Medicine, Sungkyunkwan University of School of Medicine, Seoul, Korea
Correspondence to:
Chul Won Jung, email: [email protected]
Keywords: cyclosporine, blood level, chronic graft versus host disease
Received: February 24, 2016 Accepted: June 30, 2016 Published: August 1, 2016
ABSTRACT
Introduction: It has rarely been studied that how the blood level of CsA affect the incidence of chronic GVHD after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
Methods: A total of 183 patients who underwent allo-HSCT from an HLA-matched or haplo matched family donors between 2006 and 2014 were reviewed.
Results: The average monthly CsA blood concentration (CsAavr ,ng/ml) was calculated in each patient: 0-1, 1-2, and 2-3 months after allo-HSCT. CsAavr at the first month showed significant association with the occurrence of moderate to severe cGVHD in multivariate analysis adjusted for gender, age, total body irradiation, anti-thymocyte globulin, acute GVHD ≥ grade 2 and CsAavr levels of other periods. The risk of cGVHD development was lowest in patients with CsAavr of 200-250 ng/ml when compared to those with CsAavr of ≥ 250 or < 200 ng/ml (p=0.003).
Conclusions: CsA level between 200 and 250 mg/ml during the first month after transplantation was significantly associated with the decreased risk of moderate to severe cGVHD.