Dustin Samples

Cancer Nursing Today nonprod

Tacrolimus is a standard prophylactic agent for graft-versus-host disease in patients undergoing allogeneic hematopoietic stem cell transplant. Typically, it is administered continuously in intravenous (IV) doses of 0.03 mg/kg/day based on ideal body weight (IBW). Due to logistical constraints and pump failures, researchers at the Aurora St. Luke&rsquo;s Medical Center, Milwaukee, Wisconsin, implemented an intermittent dose regiment for GHVD prophylaxis with tacrolimus. They presented their results at the 2023 Tandem Transplant and Cellular Therapy Meetings of the ASTCT and CIBMTR.After performing a literature review, Aurora St. Luke&rsquo;s Medical Center began using intermittent intravenous (IIV) tacrolimus at a starting dose of 0.015 mg/kg twice daily over 4 hours using IBW. Between January 1, 2020, and September 12, 2022, 23 patients received continuous intravenous (CIV) tacrolimus, and 17 received IIV tacrolimus for GVHD prophylaxis. The patient groups were compared for nephrotoxicity, neurotoxicity, incidence of acute GVHD, grade of acute GVHD, day 100 disease status, day 100 survival, tacrolimus levels, and days to neutrophil and platelet engraftment.One patient in the IIV group developed nephrotoxicity, as did 2 in the CIV group, but this difference was not statistically significant. None of the patients demonstrated neurotoxicity. Among the other outcome measures, the 2 groups had no significant differences.The 1 difference between the 2 groups was the tacrolimus level, which the researchers attributed to increased vigilance: &ldquo;The only statistically significant finding was an increase in tacrolimus doses in the IIV group; due to its implementation, closer monitoring was warranted initially, hence a higher number of levels in the IIV group.&rdquo;These results are encouraging because they support a regimen that alleviates the burden of administration and logistical concerns.Williams M, Mejaki B, Graff J, et al. Comparison of Intermittent Intravenous Tacrolimus to Continuous Tacrolimus in Allogeneic Stem Cell Transplant Recipients. Abstract #358. Presented at the 2023 Tandem Meetings of ASTCT and CIBMTR; February 15-19, 2023; Orlando, FL.

Continuous Versus Intermittent Tacrolimus for GVHD Prophylaxis

Conferences

Continuous intravenous tacrolimus administration can be logistically challenging. Can intermittent dosing work as well?

About Us

Editorial Policy

Authors

Advertising

eNewsletters

Contact Us

Contribute

Calendar of Events

Career Center

Blood Cancers Today

GU Oncology Now

DocWire News

MashupMD

Urban Health Today

Breast Cancer

Colorectal Cancer

GI Cancer

GU Cancer

Gynecologic Cancer Awareness Month

Gyn-Onc

Blood Cancer Awareness Month

GVHD

Leukemia

Lymphoma

Myeloproliferative Neoplasms

Multiple Myeloma

Myelodysplastic Syndrome

Myelofibrosis

Sickle Cell

Hem/Onc

Professional Development

Patient Voice

Lung Cancer

Skin Cancer

Other Tumor Types

News

Treatment

More

Calendar

CARE Award

Best Practices

Expert Interviews

Subscribe