Tacrolimus clearance is age-dependent within the pediatric population.

摘要: For prevention of graft-versus-host disease, the consensus initial intravenous dose tacrolimus for adults is 0.03 mg/kg/day. Whether target whole blood concentrations in children undergoing hematopoietic stem cell transplantation can be achieved reproducibly with this not known. We reviewed levels and calculated clearances 55 (aged 6 months to 18 years, median 9 years) using after allogeneic marrow, or cord transplantation. The regimen was mg/kg/day by continuous infusion starting on day -1 -2. At first sampling peritransplant period, 71% were within range 5-15 ng/ml, 87% safe 5-20 9% toxic, 4% subtherapeutic. Twenty-five converted oral drug recommended oral/intravenous ratio 4.0. conversion, 80% range, 20% Clearance from patients during dosing normalized ideal body weight. There a decreased clearance over 2 weeks only >12 years old (P = 0.014). did differ between age groups, but at steady state mean (+/- s.d.) higher those 12 (0.104 +/-0.068 l/h/kg). Children <6 have weight-normalized than older adults, careful therapeutic monitoring needed avoid prolonged subtherapeutic group.