Rhabdomyolysis after concomitant use of cyclosporine and simvastatin in a patient transplanted for multiple myeloma

Tong, Jiefeng; Laport, Ginna G.; Lowsky, Robert

doi:10.1038/sj.bmt.1705128

Cited by 25 publications

(14 citation statements)

References 9 publications

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“…Cyclosporine's metabolism by the cytochrome P450 3A4 is a key factor in drug-drug interactions, as it can raise levels of statins also metabolized by this pathway (lovastatin, simvastatin, and atorvastatin) and thus risk for myopathy. 37,38 FK506 and sirolimus also appear to be metabolized by this pathway. 23 However, cyclosporine also can increase statin drug levels through effects on the cell membrane transporter multidrugresistant protein 2; thus, cyclosporine can potentially increase risk for toxicity of any statin.…”

Section: Management Of Dyslipidemia In the Hsct Patientmentioning

confidence: 99%

Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management

Griffith

Savani

Boord

2010

Blood

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Section: Management Of Dyslipidemia In the Hsct Patientmentioning

confidence: 99%

Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management

Griffith

Savani

Boord

2010

Blood

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“…9,10 Such patients have been shown to recover after stopping cyclosporine and other drugs implicated in causing rhabdomyolysis and by hydrating the patient. In patients receiving tacrolimus, rhabdomyolysis has been reported uncommonly.…”

Section: Discussionmentioning

confidence: 99%

Myoglobinuria masquerading as acute rejection in a renal allograft recipient with recurrent post transplant diabetic nephropathy

Gupta¹,

Sharma

Khullar

2014

Renal Failure

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Rhabdomyolysis contributes to 7-10% of total AKI cases. Myoglobinuria as a cause of acute renal allograft dysfunction is extremely uncommon. Renal allograft recipient on cyclosporine or tacrolimus can develop myoglobinuria in presence of other precipitating factors. Present case describes an interesting report of myoglobinuria in a patient with post transplant diabetic nephropathy mimicking acute graft rejection. Clinically myoglobinuria presenting as renal allograft dysfunction is diagnosis of exclusion and renal biopsy is extremely important in making a correct diagnosis and planning optimal management in such cases.

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“…Patients who undergo stem cell transplantation usually receive many drugs, which bear an increased risk of drug interactions with statins. Rhabdomyolysis has been reported after combined treatment of HSCT patients with cyclosporine A and statins [64]. Pravastatin is not metabolized by the CYP system and currently is the only HMGCoA reductase inhibitor approved by the United States Food and Drug administration for combination treatment with cyclosporine A.…”

Section: Side Effects and Drug Interactions Of Statinsmentioning

confidence: 99%

The Use of Statins in Hematopoietic Stem Cell Transplantation

Shimabukuro‐Vornhagen

Glossmann²,

Liebig³

et al. 2009

CSCR

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Hematopoietic stem cell transplantation has become an established treatment for some patients with malignant and non-malignant hematologic diseases. More wide-spread use of this treatment modality is limited by its severe side effects. Graft-versus-host disease is a major cause of morbidity and mortality following allogeneic stem transplantation. Recent data from experimental research in murine models of GVHD and early stage clinical studies demonstrate the potential of statins in the prevention and treatment of acute and chronic GVHD. Statins are lipid lowering drugs, which reduce cholesterol production by inhibiting HMG-CoA reductase, the rate limiting enzyme of the mevalonate pathway. They are an already approved drug class with a well known toxicity profile. Besides lowering of cholesterol levels other pleiotropic effects contribute to the therapeutic activity of statins. Statins have immunomodulatory effects and inhibit a broad range of immune cells that play a role in the pathogenesis of GVHD, including antigen-presenting cells. In addition to preventing GVHD statins possess several other effects that might prove beneficial in the setting of allogeneic transplantation, such as cardiovascular protection and anti-neoplastic activity. Here we review the current knowledge on the use and effects of statins in patients who undergo allogeneic hematopoietic stem cell transplantation with a special focus on prevention and treatment of GVHD.

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Rhabdomyolysis after concomitant use of cyclosporine and simvastatin in a patient transplanted for multiple myeloma

Cited by 25 publications

References 9 publications

Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management

Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management

Myoglobinuria masquerading as acute rejection in a renal allograft recipient with recurrent post transplant diabetic nephropathy

The Use of Statins in Hematopoietic Stem Cell Transplantation

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