Pharmacokinetic of cyclosporine microemulsion in pediatric kidney recipients receiving A quadruple immunosuppressive regimen: the value of C2 blood levels.

BACKGROUND: The management of cyclosporine therapy in pediatric kidney-transplant recipients is largely based on single center's experience rather than on a univocal pharmacokinetic approach based on therapeutic drug monitoring. A prospective multicenter trial was designed to address the question whether C2 blood level monitoring of cyclosporine microemulsion therapy is feasible in the pediatric setting. METHODS: Sixty-four pediatric kidney-transplant recipients receiving a triple immunosuppressive regimen based on cyclosporine microemulsion had their cyclosporine dose adjusted to the same protocol-defined C2 targets from the time of the transplant until 2 years posttransplant. The interim analyses after 1 year of enrollment is presented in this study. RESULTS: One-year patient and graft survival were 100% and 94.8%, respectively. One-year rejection rate was 15%. C2 management of cyclosporine did not affect graft function: 1-year serum creatinine and glomerular filtration rate were 1.3+/-1 mg/mL and 71.2+/-20 mL/min/1.73 m2, respectively. C2 was the best single-point predictor of the area under the concentration curve throughout the entire follow-up, with a mean coefficient of correlation of 0.97+/-0.01. CONCLUSIONS: C2 management of cyclosporine microemulsion therapy is effective and safe in pediatric kidney-transplant recipients given a combined immunosuppressive treatment.

Reacción adversa cutánea al Imatinib durante el tratamiento de la leucemia mieloide crónica / Cutaneous adverse reaction to imatinib in the treatment of chronic myeloid leukemia

El imatinib es el tratamiento de elección para pacientes con leucemia mieloide crónica (LMC). Su objetivo es una proteína de fusión BCR-ABL con actividad kinasa y se la considera una droga con buena tolerancia; sin embargo, pueden presentarse efectos adversos que incluyen múltiples manifestaciones a nivel cutáneo, hematológico, gastrointestinal y cardiológico. La toxicidad en piel es un efecto adverso frecuente del tratamiento con imatinib, que se presenta con una frecuencia de hasta el 66% y es dependiente de la dosis administrada. Presentamos una paciente añosa con LMC que recibió tratamiento con imatinib 800 mg/día y desarrolló una erupción maculopapulosa, pruriginosa, asociada a episodio de insuficiencia cardíaca congestiva.