Cyclosporine administration practices on bone marrow transplant units: a national survey

Cyclosporine is being used with increasing frequency in the prevention and treatment of graft-versus-host disease (GVHD) in patients undergoing allogeneic bone marrow transplant (BMT). Based on the manufacturer's administration recommendations, many institutions administer cyclosporine through one lumen of a silastic catheter with the other lumen designated for hyperalimentation, antibiotics, and blood products. Administration of many antibiotics incompatible with hyperalimentation or transfusion of multiple blood products may jeopardize the patient's nutritional support. A survey was undertaken to collect information on administration practices. It was found that the majority of BMT centers used cyclosporine in their GVHD protocols and had a variety of practices for its administration. To more adequately meet the nutritional needs of this patient population, national standards for administering cyclosporine should be developed. In addition, further research is needed to determine the compatibility of cyclosporine with a variety of intravenous solutions and drugs.