TOXICITIES OF TACROLIMUS AND CYCLOSPORINE-A AFTER ALLOGENEIC BLOOD STEM-CELL TRANSPLANTATION

To determine how well tacrolimus (FK506) and cyclosporin A (CsA) are t olerated after HLA-identical blood stem cell transplantation, we perfo rmed a retrospective review of 87 adults transplanted consecutively wh o received FK506 (n = 40) or CsA (n = 47) in a nonrandomized fashion i n combination with methylprednisolone for graft-versus-host disease (G VHD) prophylaxis and compared the incidences of complications potentia lly related to the immunosuppressive agents, Pretransplant demographic characteristics, drug compliance and rates of acute GVHD were compara ble for the two groups, Following first discharge, fewer patients in t he FK506 group required antihypertensive therapy (32 vs 59%, P = 0.022 ), but more required insulin (34 vs 10%, P = 0.014), There was also a trend for more hyperkalemia and less moderate-to-severe venoocclusive disease in the FK506 group, However, nephrotoxicity, neurotoxicity, he molytic-uremic syndrome, and cytomegaloviral or fungal infections thro ugh the first 100 days post-transplant did not differ significantly be tween the two groups, We conclude that for allogeneic blood stem cell transplant recipients, the incidence of complications related to FK506 and CsA in equally effective dose schedules in combination with methy lprednisolone are similar with the exception of the risks of hypertens ion and hyperglycemia.