Kara Fortune1, Daniel Couriel. 1. Centennial Medical Center, Nashville, TN 37203, USA. kfortune@tnonc.com
Abstract
BACKGROUND: Graft-versus-host disease (GVHD) associated with allogeneic peripheral blood or marrow transplantation is a serious life-threatening complication. Most of the available literature support the use of tacrolimus as a prophylactic agent for acute GVHD. OBJECTIVE: To review the pharmacology, efficacy and safety of tacrolimus and recommend its place in therapy for the prophylaxis of GVHD. METHODS: We conducted a literature search using PubMed/Medline (January 1996 - December 2008) using the keywords tacrolimus, graft-versus-host disease and hematopoietic stem cell transplantation. Data provided by the manufacturer and the FDA were also reviewed. CONCLUSION: Tacrolimus is effective in the prevention of acute GVHD. Trials comparing tacrolimus with cyclosporine using tacrolimus levels in the 7 - 10 ng/ml range and with larger numbers of patients may be necessary to better understand the impact of these drugs on survival.
BACKGROUND:Graft-versus-host disease (GVHD) associated with allogeneic peripheral blood or marrow transplantation is a serious life-threatening complication. Most of the available literature support the use of tacrolimus as a prophylactic agent for acute GVHD. OBJECTIVE: To review the pharmacology, efficacy and safety of tacrolimus and recommend its place in therapy for the prophylaxis of GVHD. METHODS: We conducted a literature search using PubMed/Medline (January 1996 - December 2008) using the keywords tacrolimus, graft-versus-host disease and hematopoietic stem cell transplantation. Data provided by the manufacturer and the FDA were also reviewed. CONCLUSION:Tacrolimus is effective in the prevention of acute GVHD. Trials comparing tacrolimus with cyclosporine using tacrolimus levels in the 7 - 10 ng/ml range and with larger numbers of patients may be necessary to better understand the impact of these drugs on survival.
Authors: Sharon Elad; Siri Beier Jensen; Judith E Raber-Durlacher; Nancy Mouradian; Elvira M P Correa; Mark M Schubert; Nicole M A Blijlevens; Joel B Epstein; Deborah P Saunders; Tuomas Waltimo; Noam Yarom; Yehuda Zadik; Michael T Brennan Journal: Support Care Cancer Date: 2014-11-23 Impact factor: 3.603