Lower levels of cyclosporine between days 0 and +21 may reduce later relapses without increasing graft‐versus‐host disease in children and adolescents with acute lymphoblastic leukemia who undergo myeloablative TBI‐based allogeneic hematopoietic cell transplantation

摘要

Abstract Background The degree of immunosuppression required for adequate graft‐versus‐host disease (GVHD) prevention, while keeping an adequate graft‐versus‐leukemia effect, in children with acute leukemia has not been established. We report the results of a retrospective comparison of cyclosporine levels and relapse rate in children and adolescents with acute lymphoblastic leukemia (ALL). Methods Patients <21 y/o with ALL in remission who underwent TBI‐based hematopoietic cell transplantation from related or unrelated donors between 2008 and 2021 were included. Cyclosporine levels were measured twice a week and we calculated the area under the curve (AUC) from D0 to D?+?7, D?+?14, and D?+?21. Results We included 76 patients. There was a trend towards a lower incidence of relapse in patients with a mean AUC?