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Leukemia & Lymphoma Volume 49, 2008 - Issue 3
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Original Article: Clinical

Early renal injury after myeloablative cord blood transplantation in adults

Hiroshi Mae Department of Pharmacy
,
Jun Ooi Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, JapanCorrespondence[email protected]
, MD,
Satoshi Takahashi Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
,
Akira Tomonari Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
,
Nobuhiro Tsukada Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
,
Takaaki Konuma Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
,
Emi Hongo Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
,
Seiko Kato Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
,
Senji Kasahara Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
,
Maki Oiwa-Monna Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
,
Yosuke Kurokawa Department of Pharmacy
,
Arinobu Tojo Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
&
Shigetaka Asano Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
 show all
Pages 538-542 | Received 03 Sep 2007, Accepted 24 Nov 2007, Published online: 01 Jul 2009
 
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Abstract

We report a retrospective analysis of acute renal failure (ARF) in a group of 54 adult patients with hematological malignancies treated with unrelated cord blood transplantation (CBT) after myeloablative conditioning. All patients received four fractionated 12 Gy total body irradiation and chemotherapy as myeloablative conditioning. ARF was defined as the doubling serum creatinine occurring within the first 100 days after CBT. A statistically significant decrement of renal function from baseline was observed in days between 11 and 20. ARF occurred in 27.8% of patients. Although no difference was seen in maximum cyclosporine trough levels, the maximum of vancomycin (VCM) trough levels were significantly higher in patients with ARF (p = 0.01). Our result suggests that it is important to monitor VCM dosing more strictly with pharmacokinetic assessment, especially in days 11 – 20, when the most frequently observed declining renal function.

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