{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T18:28:38Z","timestamp":1749061718133,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T00:00:00Z","timestamp":1630368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Calcineurin inhibitor (CNI) use for acute graft\u2010versus\u2010host disease (aGVHD) prophylaxis in allogeneic hematopoietic cell transplantation (allo\u2010HCT) recipients has been associated with toxicities. Toxicities may be managed by converting CNI to sirolimus as often done in solid organ transplantation. This study aimed to characterize allo\u2010HCT patients who completely transitioned from tacrolimus to sirolimus and evaluate the incidence of aGVHD within 100\u00a0days post\u2010transition, overall survival (OS), and incidence of relapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Safety and efficacy data were collected at baseline and at day 30 and 90 post\u2010transition from tacrolimus to sirolimus and at one\u2010year post\u2010HCT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most patients who transitioned had acute leukemia, received a matched unrelated donor allo\u2010HCT, and transitioned due to nephrotoxicity or neurotoxicity. The resolution rate was 83% and 48% in the nephrotoxicity group, 78% and 61% in the neurotoxicity group, 33% and 33% in the group that developed both nephrotoxicity and transplant\u2010associated thrombotic microangiopathy at 30 and 90\u00a0days of assessments, respectively. Patients who transitioned before day 55 post\u2010allo\u2010HCT were more likely to develop new or worsening aGVHD. The one\u2010year OS and relapse rates were 37% and 20%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The conversion from tacrolimus to sirolimus demonstrates promising resolution of acute toxicities; however, overall mortality remains high.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.13701","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T06:37:00Z","timestamp":1629873420000},"page":"634-641","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Transitioning tacrolimus to sirolimus in allogeneic hematopoietic cell transplantation"],"prefix":"10.1111","volume":"107","author":[{"given":"Linda","family":"Arrabi","sequence":"first","affiliation":[{"name":"Department of Pharmacy Henry Ford Health System Detroit MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Jan","sequence":"additional","affiliation":[{"name":"Division of Pharmacy The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chitra","family":"Hosing","sequence":"additional","affiliation":[{"name":"Division of Cancer Medicine Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Den\u00e1i R.","family":"Milton","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7422-8951","authenticated-orcid":false,"given":"Jason","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Pharmacy The 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