Toxic serum levels of tacrolimus after topical administration in an infant with severe cutaneous graft-versus-host disease

Prot-Labarthe, Sonia; Therrien, Roxane; Champagne, Martin A.; Duval, Michel; Joubert, Clémentine

doi:10.1038/sj.bmt.1705726

Cited by 16 publications

(8 citation statements)

References 7 publications

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“…14,[26][27][28] Although the extent of TAC absorption through oral mucosa remains unclear, there is evidence for increased absorption through diseased skin. 14,[26][27][28][29][30] The mechanism behind higher absorption may be explained by impairment of the mucosal barrier in severe oral cGVHD cases. Two cases associated with intraoral topical TAC use have been reported.…”

Section: Discussionmentioning

confidence: 99%

Combined topical dexamethasone/tacrolimus therapy for management of oral chronic GVHD

Mawardi

Stevenson

Gokani

et al. 2009

Bone Marrow Transplant

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Chronic GVHD (cGVHD) frequently affects the oral cavity. The purpose of this study was to estimate the efficacy of combined topical dexamethasone (DEX) and tacrolimus (TAC) solutions in the management of oral cGVHD. The records of 14 patients with oral cGVHD treated with combined topical DEX/TAC were reviewed retrospectively. Pre-to-post treatment changes in subjective and objective measures were evaluated at a median follow-up of 60 days. Serum TAC levels were examined. Marginal objective improvement was detected at followup. The median pre-to-post treatment differences were 0.5 (range, À1 to 1) for erythema score, and 0.5 (range, 0 to 2) for lichenoid score, (P ¼ 0.06, 0.07 and 0.02, respectively). Subjective improvement was noted in three of four measures at the follow-up visit. The median differences in pain, sensitivity and dryness scores were 1 (range À1 to 6), 1 (range À3 to 5) and 2.5 (range, À5 to 5), respectively (0-10 scale, Po0.05). Four patients (37%) showed increased serum TAC levels; however, all remained within therapeutic range. In conclusion, combined topical DEX/ TAC therapy appears to be effective in reducing symptoms attributable to oral cGVHD. Our data has shown minimal evidence of systemic TAC absorption.

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Section: Discussionmentioning

confidence: 99%

Combined topical dexamethasone/tacrolimus therapy for management of oral chronic GVHD

Mawardi

Stevenson

Gokani

et al. 2009

Bone Marrow Transplant

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“…Recent literature reports its possible efficacy in an ointment formulation for GvHD of the oral mucosa [5][6][7]. However, possible systemic absorption necessitating the consequent therapeutic drug monitoring of plasma levels should be kept in mind [8].…”

Section: Introductionmentioning

confidence: 99%

Highly effective treatment with tacrolimus ointment in an adolescent with oral graft-versus-host disease

et al. 2010

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“…During the 31-day period, 525 interventions were collected (16.9 AE 3.7 per day), targeting 29 patients. The main drug-related problems were adverse drug reactions (N ¼ 125, 23.8%), untreated indication (N ¼ 92, 17.5%) and failure to receive drug (N ¼ 89, 17.0%). The pharmacist's interventions concerned mainly dose adjustment (N ¼ 174, 33.1%) and drug monitoring (N ¼ 132, 25.1%).…”

Section: Introductionmentioning

confidence: 99%

Pharmaceutical care in an inpatient pediatric hematopoietic stem cell transplant service

Prot-Labarthe

Therrien

Demanche

et al. 2008

J Oncol Pharm Pract

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A pharmacist is able to perform clinically relevant interventions in a hematopoietic stem cell transplant unit, given the complexity of the pharmacotherapy. Our description of drug-related problems and interventions may help other pharmacists already working or developing pharmaceutical care in a hematopoietic stem cell transplant unit to compare their practice and it is one of the few reported in the literature.

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Toxic serum levels of tacrolimus after topical administration in an infant with severe cutaneous graft-versus-host disease

Cited by 16 publications

References 7 publications

Combined topical dexamethasone/tacrolimus therapy for management of oral chronic GVHD

Combined topical dexamethasone/tacrolimus therapy for management of oral chronic GVHD

Highly effective treatment with tacrolimus ointment in an adolescent with oral graft-versus-host disease

Pharmaceutical care in an inpatient pediatric hematopoietic stem cell transplant service

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