| Autor: |
Martin, P, Bleyzac, N, Souillet, G, Galambrun, C, Bertrand, Y, Maire, P H, Jelliffe, R W, Aulagner, G |
| Předmět: |
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| Zdroj: |
Bone Marrow Transplantation; Oct2003, Vol. 32 Issue 8, p777-784, 8p |
| Abstrakt: |
Summary:In order to determine optimal CsA trough blood concentrations (TBC) in the early post transplantation period, we analysed relationships between TBC and acute graft-versus-host disease (aGVHD) in paediatric SCT. A total of 94 children consecutively underwent allogeneic stem cell transplantation (SCT) from: matched-sibling (MSD) (n=36), mismatched-related (MMRD) (n=3) and unrelated donors (UD) (n=55). GVHD prophylaxis usually included CsA alone or with methotrexate. Antithymocyte globulin was added in UD-SCT. TBC during the first weeks of post transplantation were estimated retrospectively by a Bayesian pharmacokinetic method and statistically associated with aGVHD. In MSD-SCT, the mean TBC during the first 2 weeks post transplantation were 42±10 and 90±7?ng/ml, respectively, in patients with grade II-IV and 0-I aGVHD (P=0.001). In SCT from UD and MMRD, TBC were 73±4 vs 95±8?ng/ml (P=0.284). For TBC >85?ng/ml, no patient developed grade II-IV aGVHD, 10 developed mild aGVHD and 30 had no aGVHD. For TBC <65?ng/ml, 7/11 patients receiving an MSD-SCT and 4/18 receiving an UD- or MMRD-SCT developed grade II-IV aGVHD. The mean TBC corresponding to each grade were: no GVHD: 101±10?ng/ml, mild: 77±11?ng/ml, moderate: 61±13?ng/ml, severe: 56±15?ng/ml (P<0.001). These results reveal a strong relationship between TBC during the early post transplantation period and the severity of aGVHD in paediatric SCT.Bone Marrow Transplantation (2003) 32, 777-784. doi:10.1038/sj.bmt.1704213 [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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