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Increased incidence of acute graft-versus-host disease with the continuous infusion of cyclosporine A compared to twice-daily infusion

Bone Marrow Transplantation, ISSN: 0268-3369, Vol: 33, Issue: 5, Page: 549-552
2004
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Article Description

We retrospectively compared the incidence of acute graft-versus-host disease (GVHD) before and after September 1999, when we changed the mode of cyclosporine A (CsA) administration from twice-daily infusions (TD) (n=58) to continuous infusion (CIF) (n=71). The incidence of grade II-IV acute GVHD in the CIF group (56%) was significantly higher than that in the TD group (27%, P=0.00022). Multivariate analysis identified only two independent significant risk factors for the development of grade II-IV acute GVHD; CIF of CsA (relative risk 2.59, 95% CI 1.46-4.60, P=0.0011) and the presence of HLA mismatch (2.01, 95% CI 1.15-3.53, P=0.014). The incidence of relapse was significantly lower in the CIF group when adjusted for disease status before transplantation (0.41, 95% CI 0.18-0.95, P=0.038), which resulted in better disease-free survival in high-risk patients (43 vs 16% at 2 years, P=0.039), but not in standard-risk patients (72 vs 80%, P=0.45). CIF of CsA with a target level of 250-400 ng/ml may not be appropriate for GVHD prophylaxis in standard-risk patients. © 2004 Nature Publishing Group All rights reserved.

Bibliographic Details

N. Ogawa; Y. Kanda; M. Matsubara; Y. Asano; M. Nakagawa; M. Sakata-Yanagimoto; K. Kandabashi; K. Izutsu; Y. Imai; A. Hangaishi; M. Kurokawa; S. Tsujino; S. Ogawa; K. Aoki; S. Chiba; T. Motokura; H. Hirai

Springer Science and Business Media LLC

Medicine

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