Nagamura F, Takahashi T, Takeuchi M, Iseki T, Ooi J, Tomonari A, Uchimaru K, Takahashi S, Tojo A, Tani K, Asano S
Department of Hematology/Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan.
Bone Marrow Transplant. 2003 Dec;32(11):1051-8. doi: 10.1038/sj.bmt.1704259.
We retrospectively analyzed the factors that affect serum cyclosporine (CsA) concentrations up to day 14 after allogeneic hematopoietic stem cell transplantation (HSCT). In all, 103 transplant recipients who received MTX and CsA for acute GVHD prophylaxis were analyzed. No significant relationships between serum CsA concentrations and gender, age, serum creatinine levels, AST/ALT levels, or antibiotic/fluconazole administration were found by comparing median CsA concentrations or by using longitudinal or regression multivariate analyses. However, the mean of the median serum CsA concentration in patients (n=54) receiving the regimen containing cyclophosphamide (CY) (149.7 ng/ml; 95% confidence interval (CI): 132.1-167.4) was significantly (P<0.0001) lower than that in patients (n=49) receiving the non-CY regimen (217.3 ng/ml; 95% CI: 198.9-235.6). Longitudinal analysis and regression multivariate analysis showed that only administration of CY had a significant effect on the serum CsA concentration. Our results suggest that administration of CY during conditioning can reduce the effects on serum CsA concentrations during the 2 weeks following HSCT. The mechanism of this effect is not clear, but it may be due to the autoinduction of CY.
我们回顾性分析了异基因造血干细胞移植（HSCT）后至第14天影响血清环孢素（CsA）浓度的因素。总共分析了103例接受甲氨蝶呤（MTX）和CsA预防急性移植物抗宿主病（GVHD）的移植受者。通过比较CsA浓度中位数或使用纵向或回归多变量分析，未发现血清CsA浓度与性别、年龄、血清肌酐水平、谷草转氨酶/谷丙转氨酶水平或抗生素/氟康唑给药之间存在显著关系。然而，接受含环磷酰胺（CY）方案的患者（n = 54）的血清CsA浓度中位数平均值（149.7 ng/ml；95%置信区间（CI）：132.1 - 167.4）显著（P < 0.0001）低于接受非CY方案的患者（n = 49）（217.3 ng/ml；95% CI：198.9 - 235.6）。纵向分析和回归多变量分析表明，只有CY的给药对血清CsA浓度有显著影响。我们的结果表明，预处理期间给予CY可降低HSCT后2周内对血清CsA浓度的影响。这种作用机制尚不清楚，但可能是由于CY的自身诱导作用。
