Analyzing the clinical outcomes of switching from cyclosporine to tacrolimus in pediatric hematopoietic stem cell transplantation

• DOI: 10.1111/ctr.14328
• Publication Date: 2021-04-25T13:19:08Z
• Authors: Koray Yalcin; Suna Celen; Suleimen Zhumatayev; Hayriye Daloglu; Dayanat Pashayev; Seda Öztürkmen; Vedat Uygun; Gulsun Karasu; Akif Yesilipek
• Keywords: Nephrotoxicity; Immunosuppression

Abstract Objective The selection of graft‐vs. ‐host disease (GvHD) prophylaxis is vital for the success hematopoetic stem cell transplantation (HSCT), and calcineurin inhibitors (CNI) have been used decades as backbone GvHD prophylaxis. aim this study to analyze results switching cyclosporine (CSA) tacrolimus because acute GvHD, engraftment syndrome (ES), persistent low level CSA, or various CSA‐associated adverse events in first 100 days pediatric HSCT. Materials Methods This a retrospective analysis 192 patients who underwent allogeneic hematopoietic at Medicalpark Göztepe Antalya Hospitals between April 2014 May 2019 had therapy switched from CSA tacrolimus‐based immunosuppression within transplant. Results reasons conversion were ( n = 70), aGvHD 63), neurotoxicity 15), nephrotoxicity 10), hypertension allergic reactions 9), ES 7), hepatotoxicity 5), vomiting 3). median day after transplant all was 20 (range 0‐100 days). Response rates 38% 86% neurotoxicity, 50% nephrotoxicity, 60% hepatotoxicity, 80% hypertension, 66% vomiting, 57% ES. Twenty‐nine (15%) experienced tacrolimus‐associated toxicities tacrolimus. Neurotoxicity emerged posterior reversible encephalopathy (PRES), which most common toxicity observed (18/29 patients). Conclusion Our data support quick condition levels with acceptable efficacy safety. Although both drugs are CNI share very similar mechanism action, could be preferred especially specific organ special attention conversion.