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Research article
Low cyclosporine concentrations in children and time to acute graft versus host disease
Hye sun Gwak
Ewha Womans University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0278-2563
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Achievement of target blood concentrations of cyclosporine (CsA) early after transplantation is known to be highly effective for reducing the incidence of acute graft versus host disease (aGVHD). However, no research has been conducted for predicting aGVHD occurrence with low CsA concentrations at different time periods. The objective of this study was to investigate the risk of aGVHD according to low CsA concentrations at lag days in children with allogenic hematopoietic stem cell transplantation (HSCT).
Methods: The records of 61 consecutive children who underwent allogeneic HSCT and received CsA as prophylaxis against aGVHD between May 2012 and March 2015 were retrospectively evaluated. The main outcome was any association between low CsA concentrations at lag days and aGVHD occurrence, which was examined for the first month after transplantation. Mean CsA concentrations at three lag periods were calculated: lag days 0-6, 7-13, and 14-20 before aGVHD occurrence.
Results: Patients whose mean CsA concentrations at lag days 0-6 did not reach the initial target concentration had 11.0-fold (95% confidence interval [CI]: 2.3-51.9) greater incidence of aGVHD. In addition, the AORs of low CsA concentrations at lag days 7-13 and 14-20 for developing aGVHD were 108.2 (95% CI: 7.7-1515.5) and 12.1 (95% CI: 1.1-138.1), respectively.
Conclusions: After low CsA concentrations are detected, careful attention needs to be paid to prevent aGVHD.
Keywords
cyclosporine, acute graft versus host disease, elapsed time, allogenic hematopoietic stem cell transplantation, children
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CURRENT STATUS: Under Review
Version 3
Posted 15 May, 2020
No community comments so far
Editor assigned
On 04 May, 2020
Editor invited
On 03 May, 2020
Submission checks complete
On 11 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 01 May, 2020
Review #1 received
Received 21 Apr, 2020
Reviewer #1 agreed
On 07 Apr, 2020
Reviewers invited
Invitations sent on 21 Feb, 2020
Editor assigned
On 19 Feb, 2020
Submission checks complete
On 18 Feb, 2020
Editor invited
On 18 Feb, 2020
No comments provided
Editorial decision: Major revision
On 30 Jan, 2020
Review #2 received
Received 28 Jan, 2020
Reviewer #2 agreed
On 25 Jan, 2020
Review #1 received
Received 23 Jan, 2020
Reviewer #1 agreed
On 08 Jan, 2020
Reviewers invited
Invitations sent on 07 Jan, 2020
Submission checks complete
On 11 Dec, 2019
Editor invited
On 11 Dec, 2019
Editor assigned
On 10 Dec, 2019
First submitted
On 08 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pediatrics
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This preprint is under consideration at BMC Pediatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Low cyclosporine concentrations in children and time to acute graft versus host disease
Hye sun Gwak
Ewha Womans University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0278-2563
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 15 May, 2020
No community comments so far
Editor assigned
On 04 May, 2020
Editor invited
On 03 May, 2020
Submission checks complete
On 11 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 01 May, 2020
Review #1 received
Received 21 Apr, 2020
Reviewer #1 agreed
On 07 Apr, 2020
Reviewers invited
Invitations sent on 21 Feb, 2020
Editor assigned
On 19 Feb, 2020
Submission checks complete
On 18 Feb, 2020
Editor invited
On 18 Feb, 2020
No comments provided
Editorial decision: Major revision
On 30 Jan, 2020
Review #2 received
Received 28 Jan, 2020
Reviewer #2 agreed
On 25 Jan, 2020
Review #1 received
Received 23 Jan, 2020
Reviewer #1 agreed
On 08 Jan, 2020
Reviewers invited
Invitations sent on 07 Jan, 2020
Submission checks complete
On 11 Dec, 2019
Editor invited
On 11 Dec, 2019
Editor assigned
On 10 Dec, 2019
First submitted
On 08 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pediatrics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Achievement of target blood concentrations of cyclosporine (CsA) early after transplantation is known to be highly effective for reducing the incidence of acute graft versus host disease (aGVHD). However, no research has been conducted for predicting aGVHD occurrence with low CsA concentrations at different time periods. The objective of this study was to investigate the risk of aGVHD according to low CsA concentrations at lag days in children with allogenic hematopoietic stem cell transplantation (HSCT).
Methods: The records of 61 consecutive children who underwent allogeneic HSCT and received CsA as prophylaxis against aGVHD between May 2012 and March 2015 were retrospectively evaluated. The main outcome was any association between low CsA concentrations at lag days and aGVHD occurrence, which was examined for the first month after transplantation. Mean CsA concentrations at three lag periods were calculated: lag days 0-6, 7-13, and 14-20 before aGVHD occurrence.
Results: Patients whose mean CsA concentrations at lag days 0-6 did not reach the initial target concentration had 11.0-fold (95% confidence interval [CI]: 2.3-51.9) greater incidence of aGVHD. In addition, the AORs of low CsA concentrations at lag days 7-13 and 14-20 for developing aGVHD were 108.2 (95% CI: 7.7-1515.5) and 12.1 (95% CI: 1.1-138.1), respectively.
Conclusions: After low CsA concentrations are detected, careful attention needs to be paid to prevent aGVHD.