In our facility, three patients developed tacrolimus (TAC)-induced renal dysfunction after allogeneic hemopoietic stem cell transplantation, although trough levels of TAC were within therapeutic ranges. They received an oral agent of slow-release TAC once a day instead of a regular form oral TAC twice a day. Following treatment with the prolonged-release agent, serum creatinine levels decreased and graft-versus-host disease (GVHD) did not occur. Use of this slow-release formulation may avoid toxic peak concentrations of TAC without the development of GVHD.
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