Lindholm A, Ringdén O, Lönnqvist B
Transplantation. 1987 May;43(5):680-4. doi: 10.1097/00007890-198705000-00016.
The efficacy and toxicity of cyclosporine (CsA) treatment for graft-versus-host disease (GVHD) was studied in 53 bone marrow transplant recipients. No correlation was found between acute or chronic GVHD and CsA dosage (daily or cumulative) or CsA plasma levels. Acute nephrotoxicity developed in 63% of the patients. Patients with nephrotoxicity had significantly higher CsA plasma levels during the first month after transplantation compared with patients without nephrotoxicity (P less than 0.05) although the cumulative CsA doses did not differ. Children had significantly fewer episodes of nephrotoxicity compared with adults (P less than 0.01). In spite of this, children received a significantly higher cumulative CsA dose (P less than 0.001). However, CsA plasma levels did not differ between children and adults, suggesting a difference in availability or elimination of the drug. Hypertension developed in 28% of the patients. Hypertensive patients tended to be younger compared with normotensive patients (P = 0.07). Nephrotoxicity tended to be less common in patients with hypertension (P = 0.06). No correlation existed between hypertension and CsA dose or CsA plasma levels. In conclusion, no correlation was found between CsA dose and GVHD or CsA toxicity, and in the single patient CsA plasma levels were of no value in predicting side effects of CsA treatment.
在53例骨髓移植受者中研究了环孢素（CsA）治疗移植物抗宿主病（GVHD）的疗效和毒性。未发现急性或慢性GVHD与CsA剂量（每日或累积剂量）或CsA血浆水平之间存在相关性。63%的患者出现急性肾毒性。与无肾毒性的患者相比，发生肾毒性的患者在移植后第一个月的CsA血浆水平显著更高（P<0.05），尽管累积CsA剂量并无差异。与成人相比，儿童发生肾毒性的次数显著更少（P<0.01）。尽管如此，儿童接受的累积CsA剂量显著更高（P<0.001）。然而，儿童和成人之间的CsA血浆水平并无差异，提示药物的可用性或消除存在差异。28%的患者出现高血压。与血压正常的患者相比，高血压患者往往更年轻（P = 0.07）。高血压患者中肾毒性往往不太常见（P = 0.06）。高血压与CsA剂量或CsA血浆水平之间不存在相关性。总之，未发现CsA剂量与GVHD或CsA毒性之间存在相关性，且在单个患者中，CsA血浆水平对预测CsA治疗的副作用并无价值。
