Blood tacrolimus concentrations in bone marrow transplant patients undergoing plasmapheresis

Microangiopathic hemolytic anemia (MAHA) is a well-described complication o f stem cell transplantation. Plasmapheresis is one modality utilized as the rapy for patients who develop this complication. However, plasmapheresis ma y alter whole blood levels of certain medications and its effect on tacroli mus in bone marrow transplant patients is unknown. Because tacrolimus has a narrow therapeutic range, the effect of plasmapheresis on whole blood conc entrations would be important to know. We report three allogeneic BMT patie nts who were receiving tacrolimus as acute GVHD therapy while undergoing pl asmapheresis for MAMA. Tacrolimus levels seemed unaffected by plasmapheresi s in these patients.