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该研究回顾性分析了某院27例由于对环胞霉素A不能耐受或无效而使用他克莫司预防急性和慢性移植物抗宿主反应(GvHD)的患者。9例患者即使血中环胞霉素A达到理想浓度仍出现急性GvHD,8例在连续使用环胞霉素A后仍出现慢性GvHD。10例患者出现2～3级(WHO评分)的环胞霉素A毒性反应。27例中超过21例他克莫司有效。接受减低调理剂量的患者与接受常规预处理方案的患者疗效相同。他克莫司具有较好的耐受性和疗效,可能成为防止GvHD的另外一种主要药物。其减少预处理剂量的原理有待进一步研究。
The study retrospectively analyzed the use of tacrolimus to prevent acute and chronic graft versus host disease (GvHD) in 27 patients in a hospital due to intolerability or ineffectiveness of cyclosporin A. Nine patients developed acute GvHD even after cyclosporin A reached the desired concentration in the bloodstream. Eight patients continued to have chronic GvHD after cyclosporine A administration. Cyclosporin A toxicity was observed in 10 patients with grade 2 to 3 (WHO score). Tacrolimus was effective in 21 of 27 patients. Patients who received a reduced conditioning dose had the same effect as those who received a conventional conditioning regimen. Tacrolimus has better tolerability and efficacy and may be another major drug for preventing GvHD. Its principle of reducing pretreatment dose needs further study.