A Restrictive Red Cell Transfusion Approach Does Not Adversely Affect Day 100 or 1 Year Survival in Multiple Myeloma Patients Undergoing Autologous Peripheral Blood Stem Cell Transplantation

s / Biol Blood Marrow Transplant 19 (2013) S257eS278 S268 29 (4-854) days. 74 patients continued on GVHD directed therapy at DLC. 20.3% of these patients had stopped PCP prophylaxis. One patient had PCP requiring hospital admission 146 days after HCT. This patient received myeloablative conditioning with ATG followed by mismatched unrelated donorHCT. At timeof PCP infection, patientwas on tacrolimus and 40mg of prednisone for GVHD treatment and was receiving pentamidine for PCP prophylaxis. In summary, the incidence of PCP is rare in the post alloHCT population. Our data suggests PCP prophylaxis can be safely discontinued if CD4+ counts > 200/uL and if not on systemic steroids. Pre-restrictive Approach Restrictive Approach Day 100 Mortality 2/100 3/100 1-year Mortality 11/100 8/100 313 Safety of Coadministaraion of Teicoplanin and Tacrolimus After Allogeneic Hematopoietic Stem Cell Transplantation Takehiko Mori, Jun Kato, Akiko Yamane, Sumiko Kohashi, Shinichiro Okamoto. Division of Hematology, Keio University School of Medicine, Tokyo, Japan Background: Tacrolimus has been widely used for the prophylaxis or treatment of graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). Among its side effects, nephrotoxicity is often clinically problematic. Recipients of HSCTare highly susceptible to the infectiondue todrug-resistant grampositivebacteria, and thus nephrotoxic glycopeptide antimicrobial agents such as teicoplanin and vancomycin are often administered. Since the nephrotoxicity of coadministration of teicoplanin and tacrolimus has yet to be evaluated, it was retrospectively evaluated in the setting of allogeneic HSCT. Patients & Methods: Recipients of allogeneic HSCT for hematological diseases who received intravenous teicoplanin for more than 4 days during the continuous intravenous infusion of tacrolimus within 30 days after transplantation were selected from the data base. Patients who received liposomal amphotericin-B or foscarnet were excluded. The data including patient demographics, whole blood concentration of tacrolimus, dose and duration of teicoplanin administration, and serum creatinine (sCr) were collected. Therapeutic drug monitoring of tacrolimus and teicoplanin was performed in all the patients. Results: Sixty-seven patients fulfilled criteria, and were included in the analysis. Median age of the patients was 48 years (range: 16-62), and median duration of the coadministration of teicoplanin and tacrolimus was 11 days (range: 440). Mean whole blood concentration of tacrolimus during teicoplanin administration were 16.3+1.7 ng/ml. Twice or greater increases of sCr compared with that before initiating teicoplanin were observed only in 2 (3.0%) of 67 patients. Nephrotoxicity was reversible andmanageable in all cases by discontinuation of teicoplanin with or without dose adjustment of tacrolimus. Conclusion: Teicoplanin can safely be coadministered with tacrolimus even in the early post-transplant period under the appropriate management with therapeutic drug monitoring of each drug.