Twice-daily intravenous bolus tacrolimus infusion: A safe and effective regimen for graft-versus-host disease prophylaxis

Objective/Background: Among patients undergoing allogeneic hematopoietic cell transplant, continuous intravenous (IV) tacrolimus infusion is frequently used for graft-versus-host disease (GvHD) prophylaxis. Twice-daily intermittent IV tacrolimus dosing may confer safety and convenience benefits. Met...

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Bibliographic Details
Main Authors: Hamza Hashmi, Shruti Bhandari, Rohit Kumar, Prashant Tripathi, Jill Blancett Rhodes, Lindsay Figg, Timothy Baize, Maxwell M. Krem, Mohamed Hegazi, Robert Emmons
Format: Article
Language:English
Published: Elsevier 2020-12-01
Series:Hematology/Oncology and Stem Cell Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S1658387620300509
Description
Summary:Objective/Background: Among patients undergoing allogeneic hematopoietic cell transplant, continuous intravenous (IV) tacrolimus infusion is frequently used for graft-versus-host disease (GvHD) prophylaxis. Twice-daily intermittent IV tacrolimus dosing may confer safety and convenience benefits. Methods: We performed a retrospective chart review of 66 patients who received twice-daily IV bolus tacrolimus for GvHD prophylaxis. The primary end point of the study was safety, as measured by renal toxicity. The secondary end points included mean tacrolimus serum concentrations, incidence of grades II–IV acute GvHD, electrolyte abnormalities, hyperglycemia, hypertension, and neurologic toxicity. Results: There was acceptable, possibly favorable, incidence of renal toxicity (42%) and no significant difference in grades II–IV GvHD (37%), compared with published data. Mean tacrolimus blood concentrations were not affected by occurrence of renal toxicity. Conclusion: We conclude that administration of IV tacrolimus twice daily over 4 h may be safe and effective in preventing GvHD in allogeneic hematopoietic cell transplant.
ISSN:1658-3876