Drug Utilization Evaluation of Cyclosporine in Allogeneic Hematopoietic Stem Cell Transplantation

Objectives: The use of cyclosporine for graft-versus host disease prophylaxis is a major factor in successful allogeneic hematopoietic stem cell transplantation. However, despite the drug being in clinical practice for more than 3 decades, there is no current global and consistent protocol for its optimal method of administration. In this study, we recorded situations related to cyclosporine administration and associated adverse reactions to aid in the development of more precise future guidelines. Materials and Methods: We monitored 22 candidates for allogeneic stem cell transplant during their hospitalization for a 1-year period, acquiring data recorded from predefined questionnaires prepared according to accredited literature, which included daily clinical and laboratory examinations. Results: Despite active attempts toward adherence to a standard protocol for cyclosporine administration, we found numerous occasions of deviations or mistakes, which may have led to adverse reactions. Conclusions: Our study, as one of the first published "drug utilization evaluations" for cyclosporine in stem cell transplant setting, proposes that educating involved clinical staff regarding a standard method of cyclosporine administration and providing efficient facilities would be highly valuable to implementation of a better practice.