Monitoring of cyclosporine serum levels in hematopoietic stem cell transplantation

• Grant number: 11/18459-4
• Support Opportunities: Regular Research Grants
• Start date: January 01, 2012
• End date: December 31, 2013
• Field of knowledge: Health Sciences - Nursing - Medical-Surgical Nursing
• Principal Investigator: Emilia Campos de Carvalho
• Grantee: Emilia Campos de Carvalho
• Host Institution: Escola de Enfermagem de Ribeirão Preto (EERP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Evidence exists that cyclosporine (CSA), an immunosuppressant used in hematopoietic stem cell transplantation, permeates silicon catheters when these are used for its infusion, so that sample collections for serum dosage of this drug through this route result in falsely high levels. Some authors recommend sample collection through peripheral access only. Others, however, have shown that these can be collected through the catheter line not used to infuse the drug; controversies still exist, though, regarding the best timing and blood volume to be discarded to collect the sample. Thus, this randomized clinical trial aims to verify whether differences exist between the samples collected through peripheral venous access, the catheter line used to infuse the drug and the line not used for infusion. Subjects will be randomly distributed in two groups. In the control group, samples will be collected from the three above-mentioned routes immediately after interrupting the drug infusion. In the experimental group, samples will be collected five minutes after the interruption. Also, in each of the groups, samples will be collected from the catheter line not used for infusion, first discarding 5ml and then 10ml of blood. This research is justified as the need for venipuncture is questioned in patients with a catheter serving, among other goals, to collect blood samples and whose peripheral venous network tends to be impaired, besides the fact that venipuncture is associated with pain and stress. On the other hand, test reliability is questioned when the sample is collected through the central venous catheter. (AU)