동종 조혈모세포 이식 후 면역억제제 복용 환자에서의 약물 부작용 평가
Adverse Drug Events of Cyclosporine and Tacrolimus in SCT patients
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Cyclosporine and tacrolimus are essential immunosuppressants for allogenic hematopoietic stem cell transplantation patients to prevent GVHD(graft versus host disease). However, these drugs have considerable interindividual variability in pharmacokinetics and a narrow therapeutic window. Maintaining optimal therapeutic blood concentration of these drugs is necessary to promote engraftment and to avoid toxicities. The side effects such as hyperlipidemia,hypertension, hyperglycemia, renal or liver dysfunction may cause a treatment-related death, and to treat these side effects may be administered with various medication. They can greatly affect the quality of life, morbidity and mortality of the patients. The objectives of this study were to evaluate the side effects of cyclosporine and tacrolimus in the allogenic hematopoietic stem cell transplantation patients under the routine clinical settings. From July 2008 to July 2009, we studied 30 patients with acute lymphocytic leukemia(ALL), acute myelogenous leukemia(AML), chronic myelogenous leukemia(CMA), aplastic anemia(AA), or myelo-dysplastic syndrome(MDS) who had received hematopoietic SCT in Yonsei University Health Care System. Patients’medical records and medication histories from graft pretreatment until discharge or death were reviewed retrospectively. We analyzed the patient's age, sex, underlying disease, donor, conditioning regimen, blood cyclosporine or tacrolimus concentration, medication side effects appeared after administration of immunosuppressive drugs, such as whether treatment-related death respectively. Results of comparing the cyclosporine and tacrolimus group did not show a big difference to hyperlipidemia, hypertension, renal dysfunction. Hyperglycemia and liver dysfunction in the tacrolimus group was significantly.
Abstract
Cyclosporine and tacrolimus are essential immunosuppressants for allogenic hematopoietic stem cell transplantation patients to prevent GVHD(graft versus host disease). However, these drugs have considerable interindividual variability in pharmacokinetics and a narrow therapeutic window. Maintaining optimal therapeutic blood concentration of these drugs is necessary to promote engraftment and to avoid toxicities. The side effects such as hyperlipidemia,hypertension, hyperglycemia, renal or liver dysfunction may cause a treatment-related death, and to treat these side effects may be administered with various medication. They can greatly affect the quality of life, morbidity and mortality of the patients. The objectives of this study were to evaluate the side effects of cyclosporine and tacrolimus in the allogenic hematopoietic stem cell transplantation patients under the routine clinical settings. From July 2008 to July 2009, we studied 30 patients with acute lymphocytic leukemia(ALL), acute myelogenous leukemia(AML), chronic myelogenous leukemia(CMA), aplastic anemia(AA), or myelo-dysplastic syndrome(MDS) who had received hematopoietic SCT in Yonsei University Health Care System. Patients’medical records and medication histories from graft pretreatment until discharge or death were reviewed retrospectively. We analyzed the patient's age, sex, underlying disease, donor, conditioning regimen, blood cyclosporine or tacrolimus concentration, medication side effects appeared after administration of immunosuppressive drugs, such as whether treatment-related death respectively. Results of comparing the cyclosporine and tacrolimus group did not show a big difference to hyperlipidemia, hypertension, renal dysfunction. Hyperglycemia and liver dysfunction in the tacrolimus group was significantly.
참고문헌 (10)
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