Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
권호 표지

Evaluation of the Current Regimen of Tacrolimus in Patients with Hematopoietic Stem Cell Transplantation

조혈모세포 이식환자에서의 현행 tacrolimus 치료방법 평가

  • Yeo, Mi-Jin (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Park, Soo-Jin (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Bang, Joon-Seok (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • La, Hyen-Oh (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • 여미진 (가톨릭대학교 서울성모병원 약제부) ;
  • 박수진 (가톨릭대학교 서울성모병원 약제부) ;
  • 방준석 (가톨릭대학교 서울성모병원 약제부) ;
  • 나현오 (가톨릭대학교 서울성모병원 약제부)
  • Received : 2010.09.30
  • Accepted : 2010.11.20
  • Published : 2010.12.31
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Abstract

Tacrolimus, an immunosuppressant prescribed against graft-versus-host disease (GVHD) in patients with allogeneichematopoietic stem cell transplantation (HSCT), is affected to change its pharmacokinetic properties by various factors. For this reason, it is needed a close monitoring to adjust dosage amount in order to optimize the blood concentration of tacrolimus is located within the effective range. According to our in-house study, 62% of HSCT-patients were needed dosage-adjustment and it is necessary to optimize the current immunosuppressive regimen in clinical settings. A retrospective study was designed to evaluate the dosing regimen (converting ratio of IV:PO=1:4) of tacrolimus in HSCT patients (n=62). After collecting data from patient's profile and medical record, pharmacokinetic parameters were calculate and compared between the estimated and the actual values in the selected subjects (n=58). It was found that the bioavailabilty (BA) of oral tacrolimus was 40.5% very much different from that is known as 25%. It implies that the current protocol has a potent risk causes dose-related toxicities to the patients. Furthermore, analyses among factors demonstrated that there was no statistical significance between BA of tacrolimus and the variable factors. In the clinical perspectives, the current converting ratio of tacrolimus in patients with HSCT to be re-considered and an appropriate and optimal alternative regimen should be adopted to prevent GVHD and to increase the quality of life of patients.

Keywords

References

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