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| Content Provider | PubMed Central |
|---|---|
| Author | Cadenas, Irene García Valcarcel, David Martino, Rodrigo Piñana, J. L. Barba, Pere Novelli, Silvana Esquirol, Albert Garrido, Ana Saavedra, Silvana Granell, Miquel Moreno, Carol Briones, Javier Brunet, Salut Sierra, Jorge |
| Copyright Year | 2014 |
| Abstract | We analyze the impact of cyclosporine (CsA) levels in the development of acute graft-versus-host disease (aGVHD) after reduced intensity conditioning allogeneic hematopoietic transplantation (allo-RIC). We retrospectively evaluated 156 consecutive patients who underwent HLA-identical sibling allo-RIC at our institution. CsA median blood levels in the 1st, 2nd, 3rd and 4th weeks after allo-RIC were 134 (range: 10–444), 219 (54–656), 253 (53–910) and 224 (30–699) ng/mL; 60%, 16%, 11% and 17% of the patients had median CsA blood levels below 150 ng/mL during these weeks. 53 patients developed grade 2–4 aGVHD for a cumulative incidence of 45% (95% CI 34–50%) at a median of 42 days. Low CsA levels on the 3rd week and sex-mismatch were associated with the development of GVHD. Risk factors for 1-year NRM and OS were advanced disease status (HR: 2.2, P = 0.02) and development of grade 2–4 aGVHD (HR: 2.5, P < 0.01), while there was a trend for higher NRM in patients with a low median CsA concentration on the 3rd week (P = 0.06). These results emphasize the relevance of sustaining adequate levels of blood CsA by close monitoring and dose adjustments, particularly when engraftment becomes evident. CsA adequate management will impact on long-term outcomes in the allo-RIC setting. |
| Related Links | http://dx.doi.org/10.1155/2014/620682 |
| Starting Page | 620682 |
| File Format | |
| ISSN | 09629351 |
| e-ISSN | 14661861 |
| Journal | Mediators of Inflammation |
| Volume Number | 2014 |
| Language | English |
| Publisher | Hindawi Publishing Corporation |
| Publisher Date | 2014-01-01 |
| Access Restriction | Open |
| Rights Holder | Hindawi Publishing Corporation |
| Subject Keyword | Immunology Cell Biology Research in Higher Education |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cell Biology Immunology |
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