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.
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Posted 15 May, 2020
On 04 May, 2020
On 03 May, 2020
On 11 Dec, 2019
On 01 May, 2020
Received 21 Apr, 2020
On 07 Apr, 2020
Invitations sent on 21 Feb, 2020
On 19 Feb, 2020
On 18 Feb, 2020
On 18 Feb, 2020
On 30 Jan, 2020
Received 28 Jan, 2020
On 25 Jan, 2020
Received 23 Jan, 2020
On 08 Jan, 2020
Invitations sent on 07 Jan, 2020
On 11 Dec, 2019
On 11 Dec, 2019
On 10 Dec, 2019
On 08 Dec, 2019
Posted 15 May, 2020
On 04 May, 2020
On 03 May, 2020
On 11 Dec, 2019
On 01 May, 2020
Received 21 Apr, 2020
On 07 Apr, 2020
Invitations sent on 21 Feb, 2020
On 19 Feb, 2020
On 18 Feb, 2020
On 18 Feb, 2020
On 30 Jan, 2020
Received 28 Jan, 2020
On 25 Jan, 2020
Received 23 Jan, 2020
On 08 Jan, 2020
Invitations sent on 07 Jan, 2020
On 11 Dec, 2019
On 11 Dec, 2019
On 10 Dec, 2019
On 08 Dec, 2019
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.
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