造血干细胞移植术后患者环孢素A血药浓度分析

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Abstract Objective To retrospectively analyze the distribution of blood concentration of Cyclosporine A(CsA)in patients after allogeneic hematopoietic stem cell transplantation(alloHSCT)and to investigate its relationship with the incidence of renal dysfunction.Methods From January 2015 to September 2016,clinical data of 110 patients who underwent alloHSCT and received CsA in our hospital were retrospectively collected.Intravenous infusion blood concentration(Cv),oral administration of valley(C0),peak concentration(C2)distribution range of patients were analyzed,and the incidence of progressive increase in serum creatinine values in different blood concentrations was counted,so as to explore the relationship between CsA and the incidence of renal dysfunction.ResultsAfter analysis,the distribution of mean blood concentration in patients with early application of CsA to prevent graft-versus-host diseases after alloHSCT was as follows∶85.45%of Cv was distributed in the range of 250-400 ng/ml,68.00%of C0in the range of 100-300 ng/ml,and 71.00%of C2in the range of 300-700 ng/ml.According to statistics,the incidence of serum creatinine values increased＞50%by CsA was 37.27%,of which 87.80%occurred during oral administration.There were significant differences in the average values of C0,C2and Cv of CsA in the non-renal dysfunction group and the renal dysfunction group (P＜0.05).With the increase of average Cv,C0,and C2values,the incidence of progressive increases in the incidence of serum creatinine values increased＞50%was significantly higher.Conclusion The nephrotoxicity of CsA may have an exposure/time cumulative effect.The situation of Cv≤300 ng/ml,C0≤200 ng/ml and C2≤400 ng/ml could significantly reduce the occurrence of renal dysfunction.

Key words： Cyclosporine A Blood concentration monitoring Renal dysfunction Allogeneic hematopoietic stem cell transplantation

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	Articles by authors
	TIAN Ji-xin
	ZHANG Ping
	WANG Xiao-dan
	LIAO Ying-xi
	LI Shan
	YAN Hai-hong

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TIAN Ji-xin,ZHANG Ping,WANG Xiao-dan, et al. Analysis of blood concentration of Cyclosporine A in patients after hematopoietic stem cell transplantation[J]. 中国当代医药, 2018, 25(22): 11-16.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I22/11

[27]	丁伶清，田雪梅，王彦娥，等.环孢素A药动学/药效学/不良反应的影响因素分析[J].中国医院药学杂志，2016，36（21）：1935-1939.
[1]	Sakai R，Taguri M，Oshima K，et al.A comparison of tacrolimus and cyclosporine combined with methotrexate for graft versus host disease prophylaxis，stratified by stem cell source∶a retrospective nationwide survey[J].Int J Hematol，2016，103（3）：322-333.
[2]	Bleyzac N，Cuzzubbo D，Rénard C，et al.Improved outcome of children transplanted for high-risk leukemia by using a new strategy of cyclosporine-based GVHD prophylaxis[J].Bone Marrow Transplant，2016，51（5）：698-704.
[3]	Gooch JL，King C，Francis CE，et al.Cyclosporine A alters expression of renal microRNAs：New insights into calcineurin inhibitor nephrotoxicity[J].PLoS One，2017，12（4）：e0175242.
[4]	Hosková L，Málek I，Kopkan L，et al.Pathophysiological mechanisms of calcineurin inhibitor-induced nephrotoxicity and arterial hypertension[J].Physiol Res，2017，66（2）：167-180.
[9]	郭锦洲（译），谢红浪（校）.改善全球肾脏病预后组织（KDIGO）临床实践指南：急性肾损伤[J].肾脏病与透析肾移植杂志，2013，22（1）：57-60.
[10]	陈新谦，金有豫，汤光，等.新编药物学（17 版）[M].北京：人民卫生出版社，2011：691-692.
[11]	周凌.环孢素A肾毒性作用的发生机制[J].国外医学泌尿系统分册，2001，21（S1）：122-125.
[14]	陈国宁，祁峰.676例环孢素A血药浓度影响因素分析[J].黑龙江医药，2016，29（6）：1080-1084.
[15]	万景，刘亚妮，师少军.中草药对环孢素药动学影响及其机制研究进展[J].中国医院药学杂志，2017，37（3）：310-315.
[5]	Da Silva JB，De Melo Lima MH，Secoli SR.Influence of cyclosporine on the occurrence of nephrotoxicity after allogeneic hematopoietic stem cell transplantation：a systematic review[J].Rev Bras Hematol Hemoter，2014，36（5）：363-368.
[6]	Yang X，Yang S，Sun A，et al.Impact of cyclosporine-A concentration in T-cell replete haploidentical allogeneic stem cell transplantation[J].Clin Transplant，2018，32（S2）：e13220.
[7]	Tafazoli A.Cyclosporine use in hematopoietic stem cell transplantation：pharmacokineticapproach[J].Immunotherapy，2015，7（7）：811-836.
[8]	Park S，Kim K，Jang JH，et al.Blood concentration of cyclosporine during early post-transplant period may have influence on the occurrence of chronic graft versus host disease in patients who received allogeneic hematopoietic stem cell transplantation[J].Oncotarget，2016，7（37）：59892-59901.
[12]	Masoumi HT，Hadjibabaie M，Vaezi M，et al.Evaluation of the interaction of intravenous and oral voriconazole with oral cyclosporine in Iranian HSCT patients[J].J Res Pharm Pract，2017，6（2）：77-82.
[13]	Van Sloten TT，De Klaver PAG，Van Den Wall Bake AWL.Co-administration of cyclosporine and ticagrelor may lead to a higher exposure to cyclosporine：a case report of a 49-year-old man[J].Br J Clin Pharmacol，2018，84（1）：208-210.
[16]	Tavakoli Ardakani M，Tafazoli A，Mehdizadeh M，et al.A 16 month survey of cyclosporine utilization evaluation in allogeneic hematopoietic stem cell transplant recipients[J].Iran J Pharm Res，2016，15（1）：331-339.
[17]	赵文明，董根山.异基因造血干细胞移植术后环孢素A血药浓度的监测分析[J].医药论坛杂志，2014，35（6）：107-109.
[18]	贾暖，孙成春，董玉波.骨髓移植患者术后环孢素血药浓度监测[J].中国医院用药评价与分析，2012，12（5）：436-437.
[19]	张涛，余晓霞，区杰彬，等.重型地中海贫血患儿移植术后环孢素 A 血药浓度分析[J].中国药房，2015，26（11）：1490-1492.
[20]	王翔岩，钟旭丽，宋泽亮，等.儿童造血干细胞移植后环孢素A血药浓度监测[J].临床药物治疗杂志，2015，13（6）：21-24.
[21]	王羽，裴云萍，方芸.造血干细胞移植中环孢素血药浓度与其不良反应的相关性研究[J].药学服务与研究，2008，8（1）：21-23.
[22]	王欣晨，商玉萍.1236例次再生障碍性贫血患者环孢素A血药浓度与其肝肾毒性的相关性研究[J].中国药师，2017，20（3）：513-515.
[23]	Machishima T，Kako S，Wada H，et al.The safety and efficacy of acute graft-versus-host disease prophylaxis with a higher target blood concentration of cyclosporine around 500 ng/ml[J].Clin Transplant，2013，27（5）：749-756.
[24]	邱蕾，张善堂，唐丽琴，等.553例次异基因造血干细胞移植受者全血环孢素浓度监测结果分析[J].安徽医药，2014，18（9）：1774-1777.
[25]	王磊，孙文利，李培余，等.环孢素A血药浓度检测方法比较分析[J].中华临床医师杂志（电子版），2017，11（3）：417-421.
[26]	贾暖，董玉波.FPIA与CMIA测定环孢素A血药浓度的相关性[J].实用医药杂志，2015，32（11）：1030-1032.