Relationship between CsA trough blood concentration and severity of acute graft-versus-host disease after paediatric stem cell transplantation from matched-sibling or ... View Full Text


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Article Info

DATE

2003-10-01

AUTHORS

P Martin, N Bleyzac, G Souillet, C Galambrun, Y Bertrand, P H Maire, R W Jelliffe, G Aulagner

ABSTRACT

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. More... »

PAGES

777-784

References to SciGraph publications

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  • 2000-08-01. Statement of current majority practices in graft-versus-host disease prophylaxis and treatment in children in BONE MARROW TRANSPLANTATION
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/sj.bmt.1704213

    DOI

    http://dx.doi.org/10.1038/sj.bmt.1704213

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1038017388

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/14520421


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    34 schema:description 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.
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