Journal
LEUKEMIA & LYMPHOMA
Volume 62, Issue 2, Pages 348-357Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/10428194.2020.1834096
Keywords
Vancomycin; trough levels; cord blood transplantation; febrile neutropenia; acute kidney injury; augmented renal clearance
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The study found that higher VCM trough levels during the first 7 days of CBT were significantly associated with an increased risk of AKI. Lower VCM trough levels may be safer for adult patients undergoing CBT with nephrotoxic drugs.
Vancomycin (VCM) is frequently used for neutropenic patients undergoing cord blood transplantation (CBT). We retrospectively examined the relationship between VCM trough levels and the efficacy and toxicity in 122 adult patients undergoing CBT in our institute. The median initial dose of VCM based on body weight was 9.1 mg/kg/dose (range, 6.0-22.6 mg/kg/dose). The median initial trough level of VCM for all patients was 4.50 mu g/mL (range, 1.20-24.05 mu g/mL), at a median of 3 days (range, 2-6 days) after VCM administration. The cumulative incidence of acute kidney injury (AKI) was 19% at 30 days after VCM administration. A higher median trough level of VCM during the first 7 days was significantly associated with the development of AKI in the multivariate analysis (Hazard ratio: 1.28, p = .026). These data suggest that a lower VCM trough level may be safe in adult patients undergoing CBT under therapy with nephrotoxic drugs.
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