دورية أكاديمية
Effect of Early Post-Transplantation Tacrolimus Concentration on the Risk of Acute Graft-Versus-Host Disease in Allogenic Stem Cell Transplantation
العنوان: | Effect of Early Post-Transplantation Tacrolimus Concentration on the Risk of Acute Graft-Versus-Host Disease in Allogenic Stem Cell Transplantation |
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المؤلفون: | Nidhi Sharma, Qiuhong Zhao, Bin Ni, Patrick Elder, Marcin Puto, Don M. Benson, Ashley Rosko, Maria Chaudhry, Srinivas Devarakonda, Naresh Bumma, Abdullah Khan, Sumithira Vasu, Samantha Jaglowski, Basem M. William, Alice Mims, Hannah Choe, Karilyn Larkin, Jonathan Brammer, Sarah Wall, Nicole Grieselhuber, Ayman Saad, Sam Penza, Yvonne Efebera |
المصدر: | Cancers, Vol 13, Iss 4, p 613 (2021) |
بيانات النشر: | MDPI AG, 2021. |
سنة النشر: | 2021 |
المجموعة: | LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
مصطلحات موضوعية: | tacrolimus, graft versus host disease, allogeneic stem cell transplantation, relapse, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
الوصف: | Acute graft versus host disease (aGVHD) remains a leading cause of morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HSCT). Tacrolimus (TAC), a calcineurin inhibitor that prevents T-cell activation, is commonly used as a GVHD prophylaxis. However, there is variability in the serum concentrations of TAC, and little is known on the impact of early TAC levels on aGVHD. We retrospectively analyzed 673 consecutive patients undergoing allo-HSCT at the Ohio State University between 2002 and 2016. Week 1 TAC was associated with a lower risk of aGVHD II–IV at TAC level ≥10.15 ng/mL (p = 0.03) compared to the lowest quartile. The cumulative incidence of relapse at 1, 3 and 5 years was 33%, 38% and 41%, respectively. TAC levels at week 2, ≥11.55 ng/mL, were associated with an increased risk of relapse (p = 0.01) compared to the lowest quartile. Subset analysis with acute myeloid leukemia and myelodysplastic syndrome patients showed significantly reduced aGVHD with TAC level ≥10.15 ng/mL at week 1 and a higher risk of relapse associated with week 2 TAC level ≥11.55 ng/mL (p = 0.02). Hence, achieving ≥10 ng/mL during the first week of HCT may mitigate the risk of aGVHD. However, levels (>11 ng/mL) beyond the first week may be associated with suppressed graft versus tumor effect and higher relapse. |
نوع الوثيقة: | article |
وصف الملف: | electronic resource |
اللغة: | English |
تدمد: | 2072-6694 |
Relation: | https://www.mdpi.com/2072-6694/13/4/613; https://doaj.org/toc/2072-6694 |
DOI: | 10.3390/cancers13040613 |
URL الوصول: | https://doaj.org/article/f2dba0dca8d246538cd7e068150e2b16 |
رقم الأكسشن: | edsdoj.f2dba0dca8d246538cd7e068150e2b16 |
قاعدة البيانات: | Directory of Open Access Journals |
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