Highlights of Pharmacist Roles in Hematopoietic Cell Transplantation and Cellular Therapy.

Patients with hematological malignancies receiving hematopoietic stem cell transplantation (HSCT) or chimeric antigen receptor (CAR) T-cell therapy are known to have complex pharmacotherapy. To ensure safe and effective care in preventing and managing drug-related problems, pharmacists trained in HSCT and CAR T-cell therapy fulfill various roles in providing care for these patients. With polypharmacy and complex medication regimens, drug interactions are one of the major aspects that pharmacists review regularly to ensure the efficacy of treatment while minimizing toxicity.

Higher Starting Dose of Ciclosporin Optimized Therapeutic Levels in Patients Receiving Phenytoin for Busulfan-induced Seizure Prophylaxis.

Background: Despite understanding the drug-drug interaction between phenytoin and ciclosporin (CsA), there is no recommended CsA dosing in patients receiving phenytoin as seizure prophylaxis in busulfan-based conditioning regimens. This drug-drug interaction has resulted in patients with sub-therapeutic levels at day 0 (D0) of allogeneic hematopoietic stem cell transplantation (alloHSCT) and at risk for acute graft-versus-host disease (aGVHD).

Objective/methods: A single-center historical-control study was conducted at Singapore General Hospital between March 2010 and July 2019 to evaluate a new dosing strategy.