Cyclosporin A oral dose determination in

hematopoietic cell transplantation(HCT) recipients

Koo Hyeonjeoung°, Ryu Seonggil, Kim Jaeyeon, Song Youngcheon

Department of Pharmacy, Asan Medical Center, Seoul, Korea

Objectives : For determination of Cyclosporin A(CsA) oral dose when changed from intravenous formulation in hematopoietic cell transplantation(HCT).

Design and Methods :This study was performed in retrospective and non-randomized study design. HCT underwent patients who received CsA were enrolled. The patients demographic data and CsA dose of initial IV dose, final IV dose, initial p.o dose, once-changed p.o dose, and duration of p.o CsA were collected via electronic medical record(EMR). The data were statistically processed by SPSS 12.0K.

Results : Total 196 patients were enrolled. The ratio that changed from intravenous form to oral formulation(po ratio_1) was 2.05±0.49(mean±s.d) After achieving steady state with capsule form, dose adjustment was done secondly and the ratio from iv form to second oral form was 1.57±0.43(mean±s.d). This ratio(po ratio_2) was considered optimal dose changing ratio from iv to po formulation in HCT patients. When grouping patients according to their actual body weight and ideal body weight, there were three groups of thin, normal and obese. And po ratio_2 was negatively correlated with obesity (r2=0.041, p=0.03) and it was 1.68±0.46(mean±s.d), 1.52±0.43 and 1.42±0.27 in thin, normal and obese patients, respectively(p=0.03).

Conclusions : It is rational to use dose ratio of around 1:1.5 when HCT patients convert their IV CsA to p.o CsA. And obese patients are required to monitor closely their blood CsA level.