Pharmacokinetics of intravenous cyclosporine in bone marrow transplant patients: Comparison of two assay methods

Gary C. Yee, Michael S. Kennedy, Rainer Storb, E. Donnall Thomas

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

The influence of assay method on steady-state cyclosporine (CsA) pharmacokinetics was studied in 18 patients with leukemia or aplastic anemia undergoing allogeneic marrow transplantation who received i.v. CsA for prophylaxis or treatment of graft-versus-host disease. Since CsA is extensively metabolized and subject to biliary elimination, CsA courses were divided according to the presence (serum bilirubin > 2.0 mg/dl) or absence (serum bilirubin ≤ 1.2 mg/dl) of hepatic dysfunction. All patients had normal renal function. Serum CsA concentrations were measured concurrently by radioimmunoassay (RIA) and high-performance liquid chromatography (HPLC). Serum concentration-time data were analyzed by standard nonlinear regression methods. Systemic clearance (CI2) calculated from HPLC results was higher than that derived from RIA results, regardless of hepatic function (P < 0.05). These data indicate that results obtained by RIA overestimate CSP concentrations, presumably because of the presence of crossreactive CSP metabolites. These differences can significantly affect derived pharmacokinetic parameters. Therefore, clinicians who make dosage recommendations based on pharmacokinetic parameters should consider the effect of assay method.

Original languageEnglish (US)
Pages (from-to)511-513
Number of pages3
JournalTransplantation
Volume38
Issue number5
DOIs
StatePublished - Nov 1984
Externally publishedYes

ASJC Scopus subject areas

  • Transplantation

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