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Graft-Versus-Host Disease

Cyclosporine short infusion and C2 monitoring in haematopoietic stem cell transplant recipients

Bone Marrow Transplantation volume 38, pages 521–525 (2006)Cite this article

Abstract

Blood concentrations of cyclosporine A (CsA) ⩾800 μg/l measured 2 h post-dosing, the C2 concentration, is necessary to obtain a maximal pharmacological effect and correlates well with transplant-related complications such as transplant rejection and toxicity. In an open crossover study CsA blood levels were measured during 24 h to generate a pharmacokinetic profile on days 1, 8 and 15 after starting CsA infusion in 21 haematopoietic allogeneic stem cell transplant recipients who were receiving intravenously CsA 3 mg/kg/day either by continuous infusion or by 2 h infusion given every 12 h. C2 levels after the 2 h infusion correlated better than C1 or C3 levels with the area under the concentration-time curve from 0 to 4 h (r2=0.62). C2 levels ⩾800 μg/l were also achieved for 20 out of 24 (83%) of cases after the 2 h infusion of CsA without any increase of CsA-related toxicity but for only three of the 23 patients (13%) after continuous infusion. Therefore, we recommend CsA infusions in 2 h during transplant and perform C2 monitoring to obtain therapeutic C2 levels ⩾800 μg/l.

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Acknowledgements

This study was supported by an unrestricted educational grant from Novartis BV, The Netherlands.

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Authors and Affiliations

  1. Department of Haematology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    M P Hendriks, N M A Blijlevens, A V M B Schattenberg & J P Donnelly

  2. Department of Clinical Pharmacy, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    D M Burger

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  1. M P Hendriks
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  2. N M A Blijlevens
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  3. A V M B Schattenberg
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  4. D M Burger
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Correspondence to M P Hendriks.

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Hendriks, M., Blijlevens, N., Schattenberg, A. et al. Cyclosporine short infusion and C2 monitoring in haematopoietic stem cell transplant recipients. Bone Marrow Transplant 38, 521–525 (2006). https://doi.org/10.1038/sj.bmt.1705481

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