2011•PubMedRequires access
[Optimal therapeutic concentration of tacrolimus in adult patients undergoing reduced-intensity cord blood transplantation].
Izumi Nasu, Tadaaki Ito, Kanako Ino, Mayumi Minowa, Masako Furusawa, Yuri Okuno, Yumiko Uchida, Kazuya Ishiwata, Nobuaki Nakano, Masanori Tsuji, Shinsuke Takagi, Hisashi Yamamoto, Naofumi Matsuno, Yuki Mori, Naoyuki Uchida, Kazuhiro Masuoka, Atsushi Wake, Shigeyoshi Makino, Shigesaburo Miyakoshi, Shuichi Taniguchi, Masahiro Hayashi
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Abstract
To investigate the effectiveness and safety of GVHD prophylaxis using FK506 alone as a continuous infusion, 104 patients who underwent reduced-intensity cord blood transplantation were retrospectively reviewed. The respective incidence of acute GVHD was 25 grade 1(24. 1%), 19 grade2(18. 3%), 15 grade3(14. 4%), and 4 grade4(3. 8%), which are comparable to that in the literature. The incidences of grade 2 and greater acute GVHD were 32 out of 69(46. 4%)for those whose wholeblood concentration of FK506 werele ss than 13 ng/mL, whereas 6 out of 35(17. 1%)for those FK5 06 were greater than 13 ng/mL. The differenceies between above and below 13 ng/mL were statistically significant(p=0. 008). There were 19 cases(18. 3%)of renal dysfunction, although none required hemodialysis. There were only 4 patients who discontinued FK506, which further confirmed the safety of FK506 alone. Together with our previous report on the upper limit of FK506(17 ng/mL)and these results, we recommend the optimal serum concentration of FK506 to range from 13 to 17 ng/ mL.