ever, the use of prophylaxis vs. empiric treatment is controversial in the setting of HSCT and data in children is limited. The concerns for using prophylaxis ...
Abstracts / Biol Blood Marrow Transplant 20 (2014) S184eS210
Background: Calcineurin inhibitors (CI) such as cyclosporine A (CsA) and tacrolimus often cause renal dysfunction resulting in an increase in serum creatinine (Cr), hyperkalemia, hypomagenesemia, and hyperuricemia. Electrolyte and uric acid abnormalities are considered mainly due to renal tubular impairment. However, the effects of CI on the sodium regulation have yet to be fully evaluated. In the present study, we have quantitatively evaluated the effects of CI on urinary sodium excretion in patients receiving tarolimus or CsA in the early period after allogenetic hematopoietic stem cell transplantation (HSCT). Patients and Methods: One hundred recipients of allogeneic HSCT receiving CI (CsA, n¼50; tacrolimus, n¼50) with the available weekly data for calculating fractional excretion of sodium (FENa) for 4-week period after transplantation were enrolled. No significant differences were observed in patient characteristics except for the type of donor between CsA and tarolimus groups. FENa was calculated according to the following formula: 100 x (Urinary sodium x Serum Cr)/ (Serum sodium x Urinary Cr). Results: Both CsA and tarolimus groups showed increase in FENa at 2nd to 4th weeks after transplantation as compared with those at 1st week (0.960.44 for CsA; 0.920.49 for tacrolimus). Among them, a significant increase was only observed at 3rd and 4th weeks in tacrolimus group, but not in CsA group. In addition, FENa was significantly higher at 4th week in tacrolimus group as compared with CsA group (1.601.12 vs. 1.130.80 :p200, and 3 were discharged on new anti-hyperglycemic medications. Conclusions: We were able to demonstrate the feasibility of implementing a program to control and track blood glucose. Not only were we able to limit hypoglycemic episodes, there was a lower rate during the intervention compared to baseline. The results of this retrospective study will allow the design of larger trials to determine whether BG control has an impact on length of stay, infectious complications, and mortality.
307 Retrospective Analysis of Oral Versus Intravenous Tacrolimus in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation Katherine Simondsen 1, Mary Mably 1, Jessica Fischer 1, Linda Eckstein 2, Blythe Gage 3, Natalie Callander 4. 1 University of Wisconsin Hospital and Clinics, Madison, WI; 2 Bone Marrow Transplant, University of Wisconsin, Madison, WI;
