Oral cyclosporine A treatment is feasible after myeloablative conditioning in allogeneic hematopoietic stem cell transplantation

J Clin Pharm Ther. 2015 Jun;40(3):358-61. doi: 10.1111/jcpt.12266. Epub 2015 Mar 31.

Abstract

What is known and objective: The target level and route of administration of cyclosporine A (CsA) differ between transplantation centres. It is unclear whether oral CsA is sufficient to maintain target level of CsA.

Case summary: We retrospectively analysed data from 48 adult patients, who underwent myeloablative hematopoietic stem cell transplantation. Twenty-one patients (44%) tolerated CsA orally throughout the transplantation period without increased incidence of acute graft versus host disease(aGVHD). Low concentration of CsA in week 2 was associated with increased incidence of aGVHD.

What is new and conclusion: Oral administration of CsA is safe, less time-consuming and economically advantageous. Close monitoring of CsA concentration is important.

Keywords: cost-effectiveness; cyclosporine; intravenous infusions; oral administration; therapeutic drug monitoring.

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Cyclosporine / administration & dosage*
  • Cyclosporine / pharmacokinetics
  • Drug Monitoring / methods
  • Female
  • Graft vs Host Disease / epidemiology
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Immunosuppressive Agents / pharmacokinetics
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Transplantation Conditioning / methods*
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Cyclosporine