Abstract
In solid organ transplantation, CYA dosing is based on the area under the concentration vs time curve (AUCinf). This study aimed to develop a guideline for the initial i.v. CYA dose for pediatric hematopoietic SCT (HSCT) patients to achieve the target AUCinf recommended in solid organ transplantation. Whole-blood CYA concentrations were determined in 24 patients (0.5–16.9 years) after the first i.v. dose given over 2 h, 1 day before HSCT. The i.v. CYA dose predicted to achieve an AUCinf of 4200 μg × h/l was calculated for each patient and expressed as a function of each patient's actual weight and body surface area (BSA). In patients ⩽9 and >9 years of age, the mean i.v. CYA dose predicted to achieve the target AUC was 2.6±0.94 and 2.1±1.21 mg/kg, respectively. When these doses were expressed in terms of BSA, the mean dose was 65±23.1 and 68±35.0 mg/m2 in children ⩽9 and >9 years of age, respectively. In children 0.5–17 years of age undergoing HSCT, we recommend an initial i.v. CYA dose of 65 mg/m2 infused over 2 h to achieve an AUCinf of approximately 4200 μg × h/l.
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Sources of financial support: This study was partially supported by an unrestricted grant from Novartis Pharmaceuticals Canada Inc., Dorval, Quebec, Canada.
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Jin, M., Seto, W., Taylor, T. et al. Determination of initial i.v. CYA dosage to achieve target AUC values in pediatric hematopoietic stem cell transplant patients. Bone Marrow Transplant 42, 455–459 (2008). https://doi.org/10.1038/bmt.2008.189
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DOI: https://doi.org/10.1038/bmt.2008.189