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Tacrolimus in adult hematopoietic stem cell transplantation.

Authors
  • Gao, Yuan1
  • Ma, Jingjing1
  • 1 Department of Pharmacy, The First Affiliated Hospital of Soochow University, Soochow University , Suzhou , China. , (China)
Type
Published Article
Journal
Expert Opinion on Drug Metabolism & Toxicology
Publisher
Informa UK (Taylor & Francis)
Publication Date
Oct 01, 2019
Volume
15
Issue
10
Pages
803–811
Identifiers
DOI: 10.1080/17425255.2019.1675635
PMID: 31595800
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Introduction: Graft-versus-host disease (GVHD) is the most common complication of hematopoietic stem cell transplantation (HSCT); therefore, the prevention of GVHD is important for a successful treatment. Tacrolimus (Tac), a calcineurin inhibitor, has been widely used for the prophylaxis of GVHD in HSCT recipients. Areas covered: This review introduces phase II/III of clinical trials related with Tac's roles in the prevention of GVHD in HSCT. Furthermore, we discuss the normal ranges of Tac concentrations, pharmacogenetics, and drug interactions of Tac, as well as its side effects in adult HSCT recipients. Expert opinion: A series of studies has established the efficacy and safety of Tac alone or in combination with other agents in HSCT. However, successful administration of Tac is complicated by its narrow therapeutic window, inter-patient pharmacokinetic variability, and a spectrum of undesirable side effects. It is necessary to maintain concentrations of Tac within the desired ranges for GVHD prophylaxis. Moreover, various factors contribute to significant variability in Tac pharmacokinetics, including drug interactions and genomic variation.

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